Current and experimental drug therapy for the treatment of polycystic ovarian syndrome

ABSTRACT

Introduction

Polycystic ovary syndrome (PCOS) is an endocrine disorder that affects 8–13% of reproductive-age women. Irregular periods, hirsutism, or infertility are the most common clinical presentations of patients affected by PCOS. This syndrome is also linked to metabolic abnormalities such as type 2 diabetes, insulin resistance and obesity. The optimal therapeutic approach is still unknown.

Areas covered

This narrative review offers an overview of the literature on current and experimental pharmacological options for treating PCOS and highlights ongoing clinical trials. Several electronic databases were searched and current research registers were analyzed to the present year. The papers selected for this review were critically analyzed, and all data available were summarized, organized, and explored to derive key information.

Expert opinion

The main goal of PCOS treatment is to obtain a metabolic and hormonal balance. Optimal PCOS therapy should be direct to the reproductive abnormalities and the entire spectrum of endocrine and metabolic complications that appear to have a long-term negative impact on PCOS patient health, as in post-menopausal period. The discovery of new mechanisms in PCOS pathogenesis will offer the possibility of testing new drug classes.

KEYWORDS:

• Polycystic ovary syndrome
• anti-androgen drugs
• insulin-sensitizing agents
• metformin
• chronic inflammation

Article highlights

• Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder of reproductive-aged women globally;

• PCOS is a syndrome of ovarian dysfunction. Its cardinal features are hyperandrogenism and polycystic ovary morphology;

• The revised diagnostic criteria of PCOS suggested that the diagnosis of PCOS should include two of the following three criteria: oligo- or anovulation, clinical and/or biochemical signs of hyperandrogenism, polycystic ovaries; it is necessary to exclude other etiologies (congenital adrenal hyperplasia, androgen-secreting tumors, Cushing’s syndrome);

• The current options employed in PCOS treatment aim to treat infertility, regulate menstrual disturbances, alleviate symptoms of hyperandrogenism, reduce weight and manage the metabolic disorder;

• A recent goal of the research is to understand the molecular mechanisms involved in the pathogenesis of PCOS; data on the pathogenetic role of chronic inflammation are growing.

• Antioxidant and anti-inflammatory therapies could be the future options of treatment for patients with PCOS.

This box summarizes key points contained in the article.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

One reviewer ia an employee at Lo.Li. Pharma s.r.l., Rome, Italy. Peer reviewers on this manuscript have no other relevant financial or other relationships to disclose

Additional information

Funding

This paper was not funded.