Pharmacological treatment of polyendocrine metabolic ovarian syndrome in adults

Polyendocrine metabolic ovarian syndrome (PMOS), previously named polycystic ovary syndrome, is a common endocrine disorder in women of reproductive age. It is associated with excessive levels of androgens and ovulatory dysfunction and has reproductive, metabolic and psychological impacts across the lifespan. Pharmacotherapy in PMOS should be directed at the concerns of the individual patient and may include the combined contraceptive pill, antiandrogen agents, metformin, antiobesity agents and ovulation induction agents. A narrative review of non-hormonal therapies was conducted. Metformin is associated with modest reductions in body weight and improves metabolic and anthropometric outcomes. Glucagon-like peptide-1 receptor agonists are an attractive option for weight loss although specific data in PMOS populations remain limited and there are safety considerations in the periconceptual setting. For ovulation induction, letrozole is the first-line agent of choice based on reassuring safety and efficacy data.