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Review
. 2022 Apr 8;23(8):4110.
doi: 10.3390/ijms23084110.

Controversies in the Pathogenesis, Diagnosis and Treatment of PCOS: Focus on Insulin Resistance, Inflammation, and Hyperandrogenism

Decio Armanini  1 , Marco Boscaro  1 , Luciana Bordin  2 , Chiara Sabbadin  1
Affiliations
Review

Controversies in the Pathogenesis, Diagnosis and Treatment of PCOS: Focus on Insulin Resistance, Inflammation, and Hyperandrogenism

Decio Armanini et al. Int J Mol Sci. .

Abstract

Polycystic ovary syndrome (PCOS) is a heterogeneous and extremely common disease with symptoms that vary with the age of the patient, typically characterized by hyperandrogenism, chronic oligo-anovulation, and/or several metabolic disorders. The syndrome includes various phenotypes, and the pathogenesis is multifactorial, often involving insulin resistance. This feature is closely related to ovarian dysfunction, inflammation, hyperandrogenism, and metabolic disorders, which characterize and complicate the syndrome. Therapy currently considers both lifestyle improvements and medications, and must be tailored on a case-by-case basis. To date, the published studies have not arrived at a definition of the most suitable therapy for each individual case and many of the drugs used are still off-label. In this review, we discuss some controversial diagnostic and therapeutic aspects of PCOS, such as the role of insulin resistance, inflammation, and hyperandrogenism. We also evaluated the advantages and disadvantages of contraceptive therapy and antiandrogens.

Keywords: aldosterone; hyperandrogenism; inositol; insulin resistance; insulin sensitizers; metformin; polycystic ovary syndrome; spironolactone.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Pathophysiology and potential therapeutic targets of PCOS.
See this image and copyright information in PMC

References

    1. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group Revised 2003 Consensus on Diagnostic Criteria and Long-Term Health Risks Related to Polycystic Ovary Syndrome (PCOS) Hum. Reprod. 2004;19:41–47. doi: 10.1093/humrep/deh098. - DOI - PubMed
    1. Teede H.J., Misso M.L., Costello M.F., Dokras A., Laven J., Moran L., Piltonen T., Norman R.J., International PCOS Network Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Clin. Endocrinol. 2018;89:251–268. doi: 10.1111/cen.13795. - DOI - PMC - PubMed
    1. Dumesic D.A., Abbott D.H., Sanchita S., Chazenbalk G.D. Endocrine-metabolic dysfunction in polycystic ovary syndrome: An evolutionary perspective. Curr. Opin. Endocr. Metab. Res. 2020;12:41–48. doi: 10.1016/j.coemr.2020.02.013. - DOI - PMC - PubMed
    1. Diamanti-Kandarakis E., Dunaif A. Insulin resistance and the polycystic ovary syndrome revisited: An update on mechanisms and implications. Endocr. Rev. 2012;33:981–1030. doi: 10.1210/er.2011-1034. - DOI - PMC - PubMed
    1. Dunaif A., Segal K.R., Shelley D.R., Green G., Dobrjansky A., Licholai T. Evidence for distinctive and intrinsic defects in insulin action in polycystic ovary syndrome. Diabetes. 1992;41:1257–1266. doi: 10.2337/diab.41.10.1257. - DOI - PubMed

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