Polycystic Ovary Syndrome Revisited: Novel Insights and Updates

Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting approximately 10% of middle-aged women worldwide. The main clinical features of PCOS include hirsutism, anovulation, irregular menstruation, and polycystic ovaries. However, the exact etiology and underlying mechanisms of PCOS remain incompletely understood. Increasing evidence suggests that a variety of factors-including environmental toxins, chronic low-grade inflammation, oxidative stress, and dysregulated insulin secretion-are involved in the onset and progression of PCOS. Additionally, abnormalities in neurotransmitter metabolism play a significant role in the pathophysiology of PCOS, particularly in relation to weight gain, hyperandrogenemia, and mood disorders. Patients with PCOS often exhibit neuroendocrine system dysfunction, characterized by altered levels of neurotransmitters such as serotonin, norepinephrine, and dopamine. These changes are closely associated with clinical symptoms such as anxiety, depression, obesity, and metabolic disturbances. Current treatment strategies for PCOS primarily focus on lifestyle modifications and pharmacological interventions. These include dietary changes, nutritional supplementation, physical activity, and ovulation induction, all aimed at alleviating symptoms and improving quality of life. Notably, interventions targeting neurotransmitter metabolism are emerging as a novel area of research. The use of antidepressants, anxiolytics, and insulin-sensitizing agents has shown potential in alleviating symptoms and regulating neuroendocrine function. Furthermore, PCOS is significantly associated with metabolic dysfunction, particularly in hormone metabolism, lipid metabolism, and glucose metabolism, which exacerbates the risk of obesity, hyperandrogenemia, and type 2 diabetes. Therefore, understanding alterations in neurotransmitter metabolism and developing new therapeutic strategies may offer novel perspectives and intervention approaches for the diagnosis and treatment of PCOS.