Treatment strategies for women with polycystic ovary syndrome

Abstract

Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women, and it is the main cause of infertility in women of reproductive age due to anovulation. PCOS also increases the risk of diseases such as cardiovascular disease and type 2 diabetes in women with this disorder. The mechanism of pathogenesis is not clear, as it may be related to heredity, the environment and internal embryonic factors; thus, the treatment strategies remain unclear. This review summarizes current treatments for PCOS worldwide. Lifestyle modification (LSM) is considered the first-line treatment, regardless of fertility status, without the addition of metformin. Oral contraceptive (OC) pills should be used as a first-line treatment for long-term management for patients with no reproductive requirements. For patients with fertility requirements, ovulation therapy is an effective treatment. For refractory ovulation disorders, patients can choose from among the latest treatments, including ovarian hippocampal signal path block theory, the theory of leptin, inositol treatment, bilateral ovarian drilling to stimulate ovulation and assisted reproductive technology. Because current treatments cannot cure PCOS, lifelong administration is still the mainstream method of management; however, the optimal treatment plan needs further research and exploration.

Chinese abstract

多囊卵巢综合征 (PCOS)是一种常见的内分泌紊乱性疾病, 是育龄妇女不排卵性不孕的主要病因, 同时它也增加了心血管疾病和II型糖尿病的发病风险。病因尚不明确, 可能和遗传、环境以及自身因素有关；因此治疗策略仍不明朗。这篇文章回顾总结了当下PCOS的治疗方法。无论是否生育或者使用二甲双胍, 改变生活方式是一线的治疗方法。口服避孕药应该被列为没有生育要求的患者长期管理的一线用药。对于有生育要求的患者, 促排卵是一种有效的治疗手段。对于难治性排卵障碍的患者, 有最新的方案可供选择, 包括卵巢海马信号通路阻断理论、瘦素肌糖治疗理论、双侧卵巢打孔刺激卵巢助孕术。因为目前仍无法治愈PCOS, 长期管理仍是治疗的主流手段, 然而, 最佳的治疗方法仍需进一步研究和探索。

Keywords:

• Polycystic ovary syndrome
• Infertile
• treatment

Disclosure statement

No potential conflict of interest was reported by the authors.