The cardiometabolic effect of current management of polycystic ovary syndrome: strategies of prevention and treatment

Abstract

Polycystic ovary syndrome (PCOS) is the commonest endocrine disorder amongst women of reproductive age, which is characterized by reproductive and cardiometabolic disturbances with long-term health repercussions. Insulin resistance (IR), impaired glucose tolerance, type 2 diabetes mellitus (DM2), obesity and dyslipidemia occur more in women with PCOS than in age-comparable women without PCOS. Long term data regarding risks or benefits of medical intervention for metabolic dysfunction of PCOS are lacking. Therapies, such as oral contraceptives (OCPs) and anti-androgenic medications used to manage the reproductive manifestations of PCOS, may themselves be the cause of cardiometabolic perturbations. Hence, strategies regarding the management of reproductive issues in PCOS encompass a patient-specific tailored approach. Factors that influence the cardiometabolic side effects arising during treatment of the reproductive manifestations of PCOS (hirsutism/anovulation) are also discussed in this paper in order to build future strategies to minimize the overall cardiometabolic risk.

Chinese abstract

多囊卵巢综合征（PCOS）是育龄妇女中最常见的内分泌紊乱, 其特征是生殖和心血管代谢紊乱, 并对健康有长期影响。 PCOS妇女的胰岛素抵抗（IR）、糖耐量受损、2型糖尿病（DM2）、肥胖和血脂异常发生率高于没有PCOS的年龄相当的女性。缺乏关于PCOS代谢功能障碍的医疗干预的风险或益处的长期数据。用于控制PCOS生殖表现的口服避孕药（OCPs）和抗雄激素药物治疗本身可能是造成心脏代谢紊乱的原因。因此, 关于PCOS生殖问题管理的策略包括针对患者量身定制的方法。本文还讨论影响PCOS生殖表现（多毛症/无排卵）治疗过程中出现的心血管代谢副作用的因素, 以便制定未来的策略, 以尽量减少心血管代谢风险。

Keywords:

• PCOS
• cardiovascular risk factors
• life style
• insulin sensitizers
• oral contraceptive pills
• anti-androgens
• cholesterol
• treatment

Disclosure statement

No potential conflict of interest was reported by the authors.