Update on the management of polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a common endocrine disorder that affects 5% to 10% of women in reproductive age. It is the most simply defined as the association of hyperandrogenism (diagnosed clinically and/or biochemically) with chronic anovulation in the absence of specific ovarian, adrenal and pituitary gland diseases. Recent studies have revealed that PCOS is associated with hyperinsulinemia and insulin resistance. Both of them have been shown to play a substantial role in the increased risk of the cardiovascular events. The new data concerning the pathogenesis and management of PCOS have changed its treatment strategy. The management of PCOS is complex and includes lifestyle modification combined with dietary-induced weight loss, oral contraceptives, clomiphene citrate, gonadotropins, antiandrogens and insulin-sensitizing agents. Women with PCOS, diagnosed and managed properly, can benefit from the reduction or even reversal of the reproductive and metabolic morbidities and from the reduction of the risk factors for cardiovascular disorders. In this article, we describe all these treatment options. Although both standard and novel therapies are discussed, this review focuses on the progress made in the recent years.