Contemporary medical therapy for polycystic ovary syndrome.
Polycystic ovary syndrome is a multi-system endocrinopathy with long-term metabolic and cardiovascular health consequences. Patients typically present due to symptoms of irregular menstruation, hair growth, or infertility; however, recent management options are aimed at further treating underlying glucose-insulin abnormalities as well as androgen excess for proactive control of symptoms. By a 2003 international consensus conference, diagnosis is made by two out of three criteria: chronic oligoovulation or anovulation after excluding secondary causes, clinical or biochemical evidence of hyperandrogenism (but not necessarily hirsutism due to inter-patient variability in hair follicle sensitivity), and radiological evidence of polycystic ovaries. Traditional medical treatment options include oral contraceptive pills, cyclic progestins, ovulation induction, and anti-androgenic medications (aldosterone antagonist, 5alpha-reductase antagonist, and follicle ornithine decarboxylase inhibitor). Recent pharmacotherapies include insulin-sensitizing medications metformin and two thiazolidinediones (rosiglitazone/Avandia and pioglitazone/Actos), a CYP19 aromatase inhibitor (letrozole/Femara), and statins to potentially lower testosterone levels.
Lanham
M S M
MS
Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan 48109-0617, USA.
Lebovic
D I
DI
Domino
S E
SE
D000152:Acne Vulgaris / Q000188:drug therapy; D000328:Adult; D002996:Clomiphene / Q000627:therapeutic use; D004965:Estrogen Antagonists / Q000627:therapeutic use; D005260:Female; D006628:Hirsutism / Q000188:drug therapy; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007247:Infertility, Female / Q000188:drug therapy*; D007333:Insulin Resistance / Q000502:physiology*; D008687:Metformin / Q000627:therapeutic use; D011085:Polycystic Ovary Syndrome / Q000188:drug therapy* / Q000503:physiopathology
D004965:Estrogen Antagonists; D007004:Hypoglycemic Agents; D002996:Clomiphene; D008687:Metformin