Recent advances in the understanding and management of polycystic ovary syndrome.
Ana L RochaFlávia R OliveiraRosana C AzevedoVirginia A SilvaThais M PeresAna L CandidoKarina Braga GomesFernando Marcos Dos ReisPublished in: F1000Research (2019)
Polycystic ovary syndrome (PCOS) is a multifaceted condition characterized by chronic anovulation and excess ovarian activity, in contrast to other causes of anovulation that involve ovarian dormancy or primary insufficiency. Recent studies indicated that PCOS is associated with low-grade chronic inflammation and that women with PCOS are at increased risk of non-alcoholic fatty liver disease. The inflammatory and metabolic derangements associated with PCOS are explained in part by the coexistence of insulin resistance and obesity but are further fueled by the androgen excess. New insights into the regulation of hormones and cytokines in muscle and fat tissue support the concept that PCOS is a systemic syndrome. The therapeutic plan should be tailored to the patient phenotype, complaints, and reproductive desire. Of note, the aromatase inhibitor letrozole seems to be more effective than the reference drug clomiphene citrate to treat infertility due to PCOS. Integral management by a multidisciplinary team may help the patients to adhere to lifestyle interventions and thereby reduce body adiposity and recover their metabolic and reproductive health.
Keyphrases
- polycystic ovary syndrome
- insulin resistance
- adipose tissue
- metabolic syndrome
- skeletal muscle
- low grade
- high fat diet
- high fat diet induced
- type diabetes
- oxidative stress
- high grade
- case report
- physical activity
- cardiovascular disease
- ejection fraction
- emergency department
- magnetic resonance
- drug induced
- body mass index
- palliative care
- fatty acid