An update on polycystic ovary syndrome: A review of the current state of knowledge in diagnosis, genetic etiology, and emerging treatment options

Abstract

Polycystic ovary syndrome is the most common endocrine disorder in women of reproductive age, which is still incurable. However, the symptoms can be successfully managed with proper medication and lifestyle interventions. Despite its prevalence, little is known about its etiology. In this review article, the up-to-date diagnostic features and parameters recommended on the grounds of evidence-based data and different guidelines are explored. The ambiguity and insufficiency of data when diagnosing adolescent women have been put under special focus. We look at some of the most recent research done to establish relationships between different gene polymorphisms with polycystic ovary syndrome in various populations along with the underestimated impact of environmental factors like endocrine-disrupting chemicals on the reproductive health of these women. Furthermore, the article concludes with existing treatments options and the scopes for advancement in the near future. Various therapies have been considered as potential treatment through multiple randomized controlled studies, and clinical trials conducted over the years are described in this article. Standard therapies ranging from metformin to newly found alternatives based on vitamin D and gut microbiota could shine some light and guidance toward a permanent cure for this female reproductive health issue in the future.

Keywords: etiology; polycystic ovary syndrome; polycystic ovary syndrome diagnosis; reproductive health; treatment options.

Figure 1.

Definitions of irregular menstruation according to gynecologic age.

Figure 2.

The hormonal cycle in the female body illustrated with the positive and negative feedback mechanisms. The diagram on the left shows a state prior to ovulation and the right after ovulation.

Figure 3.

The biosynthesis of androgen and estrogen inside the ovary.

Figure 4.

Summary of steroidogenesis with the end-products shown.