48
Views
4
CrossRef citations to date
0
Altmetric
Review

Treatment for polycystic ovary syndrome: a critical appraisal of treatment options

Pages 349-359 | Published online: 10 Jan 2014

References

  • Diamanti-Kandarakis E, Kouli C, Bergiele A et al. A survey of polycystic ovary syndrome in the Greek island of Lesbos: hormonal and metabolic profiles. J. Clin. Endocrinol. Metab.84, 4006–4011 (1999).
  • Ehrmann DA Polycystic ovary syndrome. N. Engl. J. Med.352, 1223–1236 (2005).
  • de Ugarte CM, Bartolucci AA, Azziz R. Prevalence of insulin resistance in the polycystic ovary syndrome using the homeostasis model assessment. Fertil. Steril.83, 1454–1460 (2005).
  • Rotterdam ESHRE/ASRM-sponsored Polycystic Ovary Syndrome Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil. Steril.81, 19–25 (2004).
  • Azziz R, Carmina E, Dewailly D et al. Criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. J. Clin. Endocrinol. Metab.91, 4237–4245 (2006).
  • Azziz R. The evaluation and management of hirsutism. Obstet. Gynecol.101, 995–1007 (2003).
  • Falsetti L, Gambera A, Tisi G. Efficacy of the combination ethinylestradiol and cyproterone acetate on endocrine clinical and ultrasonographic profile in polycystic ovarian syndrome. Hum. Reprod.16, 36–44 (2001).
  • Azziz R, Sanchez LA, Knockenhauser ES et al. Androgen excess in women: experience with over 1000 consecutive patients. J. Clin. Endocrinol. Metab.89, 453–462 (2004).
  • Porcile A, Gallardo E. Long-term treatment of hirsutism: desogestrel compared with cyproterone acetate in oral contraceptives. Fertil. Steril.55, 877–881 (1991).
  • Nader S. Chronic treatment of polycystic ovary syndrome: oral contraceptive pills In: Insulin Resistance and Polycystic Ovarian Syndrome. Diamanti-Kandarakis E, Nestler JE, Panidis D, Pasquale R (Eds). Humana Press, NJ, USA 29, 397–414 (2007).
  • Nader S, Diamanti-Kandarakis E. Polycystic ovary syndrome, oral contraceptives and metabolic issues: new perspectives and a unifying hypothesis. Hum. Reprod.22, 317–322 (2007).
  • Mowsowicz I, Wright F, Vincens M et al. Androgen metabolism in hirsute patients treated with cyproterone acetate. J. Steroid Biochem.20, 757–761 (1984).
  • Lobo R, Shoupe D, Serafini P, Brinton D, Horton R. The effects of two doses of spironolactone on serum androgens and anagen hair in hirsute women. Fertil. Steril.43, 200–205 (1985).
  • Unluhizara K, Kelestimur F. In: Insulin Resistance and Polycystic Ovarian Syndrome. Diamanti-Kandarakis E, Nestler JE, Panidis D, Pasquale R (Eds). Humana Press, Totowa, NJ, USA 28, 387–396 (2007).
  • Venturoli S, Marescalchi O, Colombo FM et al. A prospective randomized trial comparing low dose flutamide, finasteride, ketoconazole and cyproterone–estrogen regimen in treatment of hirsutism. J. Clin. Endocrinol. Metab.84, 1304–1310 (1999).
  • Erenus M, Gurbuz O Durmusoglu F, Demircay Z, Pelcin S. Comparison of efficacy of spironolactone versus flutamide in treatment of hirsutism. Fertil. Steril.61, 613–616 (1994).
  • Calaf J, Loper E, Millet A et al. Long-term efficacy and tolerability of flutamide combined with oral contraceptives in moderate to severe hirsutism: a 12 month double blind parallel clinical trial. J. Clin. Endocrinol. Metab.92, 3446–3452 (2007).
  • Ibanez L, Jamarillo A, Ferrer A, de Zegher F. Absence of hepatotoxicity after long-term, low dose flutamide in hyperandrogenic girls and young women. Hum. Reprod.20, 833–836 (2005).
  • Dallob AL, Sadick NS, Unger W et al. The effect of finasteride, a 5 αreductase inhibitor on scalp skin, testosterone and dihydrotestosterone concentrations I patients with male pattern baldness. J. Clin. Endocrinol. Metab.79, 703–706 (1994).
  • Bayram F, Muderris I I, Sahin Y, Kelestimur F. Finasteride treatment for one year in 35 hirsute patients. Exp. Clin. Endocrinol. Diab.107, 195–197 (1999).
  • Lumachi F, Rondinone R. Use of cyproterone acetate, finasteride and spironolactone to treat idiopathic hirsutism. Fertil. Steril.79, 942–94 (2003).
  • Erenus M, Yucelten , Durmusoglu F, Gurbuz O. Comparison of finasteride versus spironolactone in the treatment of idiopathic hirsutism. Fertil. Steril.68, 1000–1003 (1997).
  • Sahin Y, Dilber S, Kelestimur F. Comparison of Diane 35 and Diane 35 plus finasteride in the treatment of hirsutism. Fertil. Steril.75, 496–500 (2001).
  • Sahin Y, Bayram F, Kelestimur F, Muderris I. Comparison of cyproterone acetate plus ethinylestradiol and finasteride in the treatment of hirsutism. J. Endocrinol. Invest.21, 348–352 (1998).
  • Kumar A, Woods KS, Bartolucci AA, Azziz R. Prevalence of adrenal androgen excess in patients with the polycystic ovary syndrome. Clin. Endocrinol.62, 644–649 (2005).
  • Carmina E, Lobe RA. The addition of dexamethasone to antiandrogen therapy for hirsutism prolongs duration of remission. Fertil. Steril.69, 1075–1079 (1998).
  • Spritzer P, Billaud L, Thalabard JC et al. Cyproterone acetate versus hydrocortisone treatment in late onset adrenal hyperplasia. J. Clin. Endocrinol. Metab.70, 642–646 (1990).
  • Azziz R, Ochoa TM, Bradley L Jr, Potter HT, Boots LR. Leuprolide and estrogen versus oral contraceptive pills for the treatment of hirsutism: a prospective randomized study. J. Clin. Endocrinol. Metab.80, 3406–3411 (1995).
  • Carmina E, Lobo RA. Gonadotropin releasing hormone agonist therapy for hirsutism is as effective as high dose cyproterone acetate but results in longer remission. Hum. Reprod.12, 663–666 (1997).
  • Yilmaz M, Karakoc A, Toruner FB et al. The effects of rosiglitazone and metformin on menstrual cyclicity and hirsutism in polycystic ovary syndrome. Gynecol. Endocrinol.21(3), 154–160 (2005).
  • Costello M, Shrestha B, Eden J, Sjoblom P, Johnson M. Insulin sensitizing drugs versus the combined oral contraceptive pill for hirsutism, acne and risk of diabetes, cardiovascular disease and endometrial carcinoma in polycystic ovary syndrome. Cochrane Database of Syst. Rev.1, CD0005552 (2007).
  • Azziz R, Ehrman D, Legro R et al. Troglitazone improves ovulation and hirsutism in polycystic ovary syndrome: a multi-center, double-blind placebo-controlled trial. J. Clin. Endocrinol. Metab.86, 1626–32 (2001).
  • Olsen EA. Methods of hair removal. J. Am. Acad. Dermatol.40, 143–155 (1999).
  • Haedersdal M, Wulf HC. Evidence-based review of hair removal using laser and light sources. J. Eur. Acad. Dermatol. Venereol.20, 9–20 (2006).
  • Malhotra B, Noveck R, Behr D, Palmisano M. Percutaneous absorption and pharmacokinetics of eflornithine HCL 13.9% cream in women with unwanted facial hair. J. Clin. Pharmacol.41, 972–978 (2001).
  • Martin KA, Chang RJ, Ehrmann DA et al. Evaluation and treatment of hirsutism in premenopausal women: an Endocrine Society Clinical Practice Guideline. J. Clin. Endocrinol. Metab.93, 1105–1120 (2008).
  • Huber J, Walch K. Treating acne with oral contraceptives: use of lower doses. Contraception73, 23–29 (2006).
  • James WD. Acne. N. Engl. J. Med.352, 1463–1472 (2005).
  • Shapiro J. Hair loss in women. N. Engl. J. Med.357, 1620–1630 (2007).
  • Vigil P, Contreras P, Alvarado JL, Godoy A, Salgado A, Cortes ME. Evidence of subpopulations with different levels of insulin resistance in women with polycystic ovary syndrome. Hum. Reprod.22(11), 2974–2980 (2007).
  • Legro RS, Castracane VD, Kauffman RP. Detecting insulin resistance in polycystic ovary syndrome: purpose and pitfalls. Obstet. Gynecol. Survey59, 141–154 (2004).
  • Carmina E, Legro RS, Stamets K, Lowell J, Lobo RA. Difference in body weight between American and Italian women with polycystic ovary syndrome: influence of the diet. Hum. Reprod.18(11), 2289–2293 (2003).
  • Dunaif A. Insulin resistance and polycystic ovary syndrome: mechanisms and implications for atherogenesis. Endocr. Rev.18, 774–800 (1997).
  • Legro RS, Kunselman AR, Dunaif A. Prevalence and predictors of dyslipidemia in women with polycystic ovary syndrome. Am. J. Med.111, 607–613 (2001).
  • Third report of the National Cholesterol Education Program. Expert panel on the detection, evaluation and treatment of high blood cholesterol in adults. Final report. Circulation106, 3143–3421 (2002).
  • Talbot EO, Guzick DS, Sutton-Tyrrell K et al. Evidence for association between polycystic ovary syndrome and premature carotid atherosclerosis in middle-aged women. Arterioscler. Thromb. Vasc. Biol.20, 2414–2421 (2000).
  • Vryonidou A, Papatheodorou A, Tauridou A et al. Association of hyperandrogenism and metabolic phenotype with carotid intima-media thickness in young women with polycystic ovary syndrome. J. Clin. Endocrinol. Metab.90, 2740–2746 (2005).
  • Luque-Ramirez M, Mendieta-Azcona C, Alvarez-Blasco F, Escobar-Morreale HF. Androgen excess is associated with increased carotid intima-media thickness observed in young women with polycystic ovary syndrome. Hum. Reprod.22, 3197–3203 (2007).
  • Christian R, Dumesic DA, Behrenbeck T, Oberg AL, Sheedy PF, Fitzparick LA. Prevalence and predictors of coronary artery calcification in women with polycystic ovary syndrome. J. Clin. Endocrinol. Metab.88, 2562–2568 (2003).
  • Wynn V, Doar JWH. Some effects of oral contraceptives on carbohydrate metabolism. Lancet7624(2), 761–765 (1969).
  • Baillargeon JP, McClisk DK, Essah PA, Nestler J. Association between the current use of low-dose oral contraceptives and cardiovascular arterial disease: a meta-analysis. J. Clin. Endocrinol. Metab.90, 3863–3870 (2005).
  • Scheen AJ, Jandrain BJ, Humblet DMP, Jaminet CB, Gaspard UJ, Lefebvre PJ. Effects of one year treatment with low-dose combined oral contraceptives containing ethinylestradiol and cyproterone acetate on glucose and insulin metabolism. Fertil. Steril.59, 797–802 (1993).
  • Perseghin G, Scifo G, Pagliato E et al. Gender factors affecting fatty acids-induced insulin resistance in non-obese humans: effects of oral steroidal contraception. J. Clin. Endocrinol. Metab.86, 3188–3196 (2001).
  • Godsland IF. The influence of female sex steroids on glucose metabolism and insulin action. J. Intern. Med. Suppl.738, 1–60 (1996).
  • Escobar-Morreale H, Lasuncion MA, Sancho J. Treatment of hirsutism with ethinylestradiol–desogestrel has beneficial effects on lipid profiles and improves insulin sensitivity. Fertil. Steril.74, 816–819 (2000).
  • Pasquali R, Gambineri A, Anconetani et al. The natural history of the metabolic syndrome in young women with polycystic ovary syndrome and the effect of long-term estrogen-progestogen treatment. Clin. Endocrinol.50, 517–527 (1999).
  • Korytkowski MT, Mokan M, Horwitz J, Berga SL. Metabolic effects of oral contraceptives in women with polycystic ovary syndrome. J. Clin. Endocrinol. Metab.80, 3327–3334 (1995).
  • Nader S, Riad-Gabriel MG, Saad MF. The effect of desogestrel-containing oral contraceptives on glucose tolerance and leptin concentrations in hyperandrogenic women. J. Clin. Endocrinol. Metab.82, 3074–3077 (1997).
  • Sharma ST,Wickham III EP, Nestler JE. Changes in glucose tolerance with metformin treatment in polycystic ovary syndrome: a retrospective analysis. Endo. Prac.13(4), 373–379 (2007).
  • Trolle B, Flyvbjerg A, Kesmodel U, Lauszus FF. Efficacy of metformin in obese and non-obese women with polycystic ovary syndrome: a randomized, double-blinded, placebo-controlled, cross-over trial. Hum. Reprod.22(11), 2967–2973 (2007).
  • Nissen SE, Wolski K. Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes. N. Engl. J. Med.356, 2457–2471 (2007).
  • Salley KES, Wickham EP, Chiang KI, Essah PA, Karjane NW, Nestler JE. Position statement: glucose intolerance in polycystic ovary sundrome – a position statement of the Androgen Excess Society. J. Clin. Endocrinol. Metab.92, 4546–4556 (2007).
  • Ibanez L, Lopez-Bermejo A, del Rio L, Enriquez G, Valls C, de Zegher F. Combined low-dose pioglitazone, flutamide and metformin for women with androgen excess. J. Clin. Endocrinol. Metab.92, 1710–1714 (2007).
  • Ibanez L, Valls C, Cabre S, de Zegher F. Flutamide–metformin plus ethinylestradiol–drospirenone for lipolysis and anti-atherogenesis in young women with ovarian hyperandrogenism: the key role of early low-dose flutamide. J. Clin. Endocrinol. Metab.89, 4716–4720 (2004).
  • Norman RJ, Noakes M, Wu R, Davies MJ, Moran L, Wang XJ. Improving reproductive performance in overweight/obese women with effective weight management. Hum. Reprod. Update10, 267–280 (2004).
  • Wadden TA, Berkowitz R, Womble LG et al. Randomized trial of lifestyle modification and pharmacotherapy for obesity. N. Engl. J. Med.353, 2111–2120 (2005).
  • Escobar-Morreale HF, Botella-Carretero JI, Alvarez-Blasco F, Sancho J, San Millan JL. The polycystic ovary syndrome association with morbid obesity may resolve after weight loss induced by bariatric surgery. J. Clin. Endocrinol. Metab.90, 6364–6369 (2005).
  • Eid GM, Cottam DR, Velcu et al. Effective treatment of polycystic ovarian syndrome with Roux-en-Y gastric bypass. Surg. Obes. Relat. Dis.1(2), 77–80 (2005).
  • Sjostrom L, Narbro K, Sjostrom CD et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N. Engl. J. Med.357, 741–52 (2007).
  • Banaszewska B, Pawelczyk L, Spaczynski RZ, Dzivra J, Dubela AJ. Effects of simvastatin and oral contraceptive agent on polycystic ovary syndrome: prospective, randomized cross-over trial. J. Clin. Endocrinol. Metab.92, 456–461 (2007).
  • Arslanian SA, Lewy V, Danadian K, Saad R. Metformin therapy in obese adolescents with polycystic ovary syndrome and impaired glucose tolerance: amelioration of exaggerated adrenal response to adrenocorticotropin with reduction of insulinemia/insulin resistance. J. Clin. Endocrinol. Metab.87, 1555–1559 (2002).
  • Glueck CJ, Aregawi D, Winiorska M et al. Metformin-diet ameliorates coronary heart disease risk factors and facilitates resumption of regular menses in adolescents with polycystic ovary syndrome. J. Pediatr. Endocrinol. Metab.19, 831–842 (2006).
  • Mastorakos G, Koliopoulos C, Creatsas G. Androgen and lipid profiles in adolescents with polycystic ovary syndrome who were treated with two forms of combined oral contraceptives. Fertil. Steril.77, 919–927 (2002).
  • Ibanez L, de Zegher F. Low dose flutamide-metformin therapy for hyperinsulinemic, hyperandrogenism in non-obese adolescents and women. Hum. Reprod. Update12, 242–252 (2006).
  • Franks S, Mason H, Willis D. Follicular dynamics in the polycystic ovary syndrome. Mol. Cell. Endocrinol.163, 49–52 (2000).
  • Webber LJ, Stubbs S, Stark J et al. Formation and early development of follicles in the polycystic ovary syndrome. Lancet362, 1017–1021 (2003).
  • Imani B, Eijkemans MC, Te Velde ER, Habea JDF, Fauser BCJM. Predictors of patients remaining anovulatory during clomiphene citrate induction of ovulation in normogonadotropic oligoamenorrheic infertility. J. Clin. Endocrinol. Metab.83, 2361–2365 (1998).
  • Santbrink RJ, Fauser BC. Ovulation induction in normogonadotropic anovulation (PCOS). Best Prac. Res. Clin. Endocrinol. Metab.20, 261–270 (2006).
  • White DM, Polson DW, Kiddy et al. Induction of ovulation with low-dose gonadotropins in polycystic ovary syndrome: an analysis of 109 pregnancies in 225 women. J. Clin. Endocrinol. Metab.81, 3821–3824 (1996).
  • Delbaere A, Smits G, Olatunbosun O, Pierson R, Vassart G, Costagliola S. New insights into the pathophysiology of ovarian hyperstimulation syndrome. What makes the difference between spontaneous and iatrogenic syndrome? Hum. Reprod.19(3), 486–489 (2004).
  • Lord JM, Flight IHK, Norman RJ Metformin in polycystic ovary syndrome: systematic review and meta-analysis. Br. Med. J.327, 951–953 (2003).
  • Moll E, Bassuyt PM, Korevaar JC, Lambalk CB, van der Veen F. Effect of clomiphene citrate plus metformin and clomiphene citrate plus placebo on induction of ovulation in women with newly diagnosed polycystic ovary syndrome: a randomized double blind clinical trial. Br. Med. J.332, 1485–1488 (2006).
  • Palomba S, Orio Jr F, Falbo A et al. Prospective parallel randomized double-blind double dummy controlled clinical trial comparing clomiphene citrate and metformin as first line treatment for ovulation induction in non-obese anovulatory women with polycystic ovary syndrome. J. Clin. Endocrinol. Metab.90, 4068–4074 (2005).
  • Palomba S, Orio Jr F, Falbo A Russo T, Tolino A, Zullo F. Clomiphene citrate versus metformin as first-line approach for the treatment of anovulation in infertile patients with polycystic ovary syndrome. J. Clin. Endocrinol. Metab.92, 3498–3503 (2007).
  • Neveu N, Granger L, St Michel P, Lavoie HB. Comparison of clomiphene citrate, metformin or the combination of both for first-line ovulation induction and achievement of pregnancy in 154 women with polycystic ovary syndrome. Fertil. Steril.87, 113–120 (2007).
  • Legro RS, Barnhart HX, Schlaff WD et al. Clomiphene, metformin or both for infertility in the polycystic ovary syndrome. N. Engl. J. Med.356, 551–566 (2007).
  • Moll E, van der Veen F, van Wely M. The role of metformin in polycystic ovary syndrome: a systematic review. Hum. Reprod. Update13(6), 527–537 (2007).
  • Sepilian V, Nagamani M. Effects of rosiglitazone in obese women with polycystic ovary syndrome and severe insulin resistance. J. Clin. Endocrinol. Metab.90, 60–65 (2005).
  • Rouzi AA, Ardawi MSM. A randomized controlled trial of the efficacy of rosiglitazone and clomiphene citrate versus metformin and clomiphene citrate in women with clomiphene citrate-resistant polycystic ovary syndrome. Fertil. Steril.85, 428–435 (2006).
  • Casper RF, Mitwally MF. Review: aromatase inhibitors for ovulation induction. J. Clin. Endocrinol. Metab.91, 760–771 (2006).
  • Bayar U, Basaran M, Kiran S, Coskun A, Gezer S. Use of an aromatase inhibitor in patients with polycystic ovary syndrome: a prospective randomized trial. Fertil. Steril.86, 1447–1451 (2006).
  • Tulandi T, Martin J, Al-Fadhli R et al. Congenital malformations among 911 newborns conceived after infertility treatment with letrozole or clomiphene citrate. Fertil. Steril.85, 1761–1765 (2006).
  • Elnashar A, Abdelmageed E, Fayed M, Sharaf M. Clomiphene citrate and dexamethasone in treatment of clomiphene citrate-resistant polycystic ovary syndrome: a prospective placebo-controlled study. Hum. Reprod.21(7), 1805–1808 (2006).
  • Farquhar C, Lilford RJ, Marjoribanks J, Vandekerckhove P. Laparoscopic drilling by diathermy or laser for ovulation induction in anovulatory polycytic ovary syndrome. Cochrane Database Syst. Rev.3, CD001122 (2007).
  • Palomba S, Zollo F, Diamanti-Kandarakis E, Orio F Jr. Surgery and laser diathermy. In: Insulin Resistance and Polycystic Ovarian Syndrome. Diamanti-Kandarakis E, Nestler JE, Panidis D, Pasquale R (Eds). Humana Press, NJ, USA 33, 461–477 (2007)
  • Palomba S, Orio F Jr, Nardo LG et al. Metformin administration versus laparoscopic ovarian diathermy in clomiphene citrate-resistant women with polycystic ovary syndrome: a prospective parallel randomized double-blind placebo-controlled trial. J. Clin. Endocrinol. Metab.89, 4801–4809 (2004).
  • Ibanez L, Lopez-Bermejo A, Callejo J et al. Plycystic ovaries in non-obese adolescents and young women with ovarian androgen excess: relation to prenatal growth. J. Clin. Endocrinol. Metab.93, 196–199 (2008).
  • Nader S. Adrenarche and polycystic ovary syndrome: a tale of two hypotheses. J. Pediatr. Adolesc. Gynecol.20, 353–360 (2007).

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.