Polycystic Ovary Syndrome: A Literature Review With a Focus on Diagnosis, Pathophysiology, and Management

Abstract

In females with polycystic ovarian syndrome (PCOS), the most prevalent endocrine condition is chronic anovulation and hyperandrogenism. This illness influences females from conception to death, posing several risks to the health of a female, thus reducing the quality of life. It also increases the rates of mortality and morbidity. The first years of puberty are when PCOS symptoms first show. Menstrual irregularities, anovulation, and acne are features of both PCOS and typical puberty in females. There are many various phenotypes that fall under the same illness, so it is necessary to examine each one independently because they may need different treatments and result in different outcomes. Depending on the diagnostic criteria, approximately 6%-20% of females in the reproductive age group are believed to be affected by PCOS. As long as PCOS is still a syndrome, no single diagnostic indicator, such as hyperandrogenism or polycystic ovary (PCO), can be used to make a clinical diagnosis. The management of females with PCOS depends on the symptoms. These could include menstruation problems, androgen-related symptoms, or infertility caused by ovulatory disruption. In females with PCOS, anovulation is linked to low follicle-stimulating hormone (FSH) levels and a halt in antral follicle growth during the last stages of maturation. The condition may be treated surgically with laparoscopic ovarian drilling or medically with medications such as aromatase inhibitors, metformin, glucocorticoids, clomiphene citrate (CC), tamoxifen, or gonadotropins. Patients will experience different androgenic symptoms, such as hirsutism, acne, and/or baldness. Patients who appear with these troubling symptoms need to receive appropriate care. The review emphasizes the role it plays in the management of various conditions.

Keywords: diagnostic criteria; hyperandrogenism; insulin resistance; pcos treatment; polycystic ovary syndrome.

Figure 1. Clinical manifestations of PCOS in different stages of life of females

Credits: Shrutika Waghmare IUGR, intrauterine growth retardation; SGA, small for gestational age; PCOS, polycystic ovarian syndrome

Figure 2. Four different phenotypes of polycystic ovarian syndrome (PCOS)

Credits: Shrutika Waghmare

Figure 3. Summarized scheme regarding the pathophysiology of PCOS

Credits: Shrutika Waghmare ↑, increased; ↓, decreased; LH, luteinizing hormone; FSH, follicle-stimulating hormone; E2, estradiol; PCOS, polycystic ovarian syndrome