The management of patients with polycystic ovary syndrome

Jayasena, Channa N.; Franks, Stephen

doi:10.1038/nrendo.2014.102

Cited by 196Ovarian function and disordersEndometriosis Research and TreatmentDiabetes, Cardiovascular Risks, and Lipoproteins

The management of patients with polycystic ovary syndrome

Jayasena, Channa N., Franks, Stephen·2014·Nature Reviews Endocrinology

DOI 10.1038/nrendo.2014.102

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Abstract

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women. The syndrome is typified by its heterogeneous presentation, which includes hirsutism (a function of hypersecretion of ovarian androgens), menstrual irregularity and infertility (that is due to infrequent or absent ovulation). Furthermore, PCOS predisposes patients to metabolic dysfunction and an increased risk of type 2 diabetes mellitus (T2DM). The aetiology of the syndrome has a major genetic component. Obesity exacerbates the insulin resistance that is a feature of PCOS in many women and amplifies the clinical and biochemical abnormalities. In clinical practice, the choice of investigations to be done depends mainly on the presenting symptoms. The approach to management is likewise dependent on the presenting complaint. Symptoms of androgen excess (hirsutism, acne and alopecia) require cosmetic measures, suppression of ovarian androgen function and anti-androgen therapy, alone or in combination. Ovulation rate is improved by diet and lifestyle intervention in overweight individuals but induction of ovulation by, in the first instance, anti-estrogens is usually required. Monitoring of glucose is important in overweight women and/or those with a family history of T2DM. Metformin is indicated for women with impaired glucose tolerance but whether this drug is otherwise useful in women with PCOS remains debatable.

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Women with PCOS are often obese, develop IR and are at risk of developing T2D.
“Women with PCOS are often obese, develop IR and are at risk of developing T2D [187, 188].”
From Role of sex hormone-binding globulin in the free hormone hypothesis and the relevance of free testosterone in androgen physiology (2022) · cites this paper as [188]

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Roles of estrogen and its receptors in polycystic ovary syndrome
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Association between hyperandrogenism and adverse pregnancy outcomes in patients with different polycystic ovary syndrome phenotypes undergoing in vitro fertilization/intracytoplasmic sperm injection: a systematic review and meta-analysis
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Roles of the Notch Signaling Pathway in Ovarian Functioning
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Prevalence of polycystic ovary syndrome in patients with type 2 diabetes: A systematic review and meta-analysis
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Is polycystic ovary syndrome associated with risk of female sexual dysfunction? A systematic review and meta-analysis
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Insulin-Sensitizers, Polycystic Ovary Syndrome and Gynaecological Cancer Risk
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A Dietary Medium-Chain Fatty Acid, Decanoic Acid, Inhibits Recruitment of Nur77 to the HSD3B2 Promoter In Vitro and Reverses Endocrine and Metabolic Abnormalities in a Rat Model of Polycystic Ovary Syndrome
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Shift Work Is Associated with Metabolic Syndrome in Young Female Korean Workers
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Excess Cardiovascular Risk in Diabetic Women: A Case for Intensive Treatment
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Nanocomposites based on nanoceria regulate the immune microenvironment for the treatment of polycystic ovary syndrome
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Free Testosterone Reflects Metabolic as well as Ovarian Disturbances in Subfertile Oligomenorrheic Women
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Menstrual Cycle Patterns and the Prevalence of Premenstrual Syndrome and Polycystic Ovary Syndrome in Korean Young Adult Women
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Metformin: Repurposing Opportunities for Cognitive and Mood Dysfunction
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Authors: Jayasena, C. N., & Franks, S.
Affiliations: Hammersmith Hospital (GB)
Corresponding author: Franks, Stephen
ORCID: Jayasena, Channa N.
Franks, Stephen
Venue: Nature Reviews Endocrinology
Publisher: Springer Science and Business Media LLC
Published: 2014-07-15
Volume: 10
Issue: 10
Pages: 624-636
ISSN: 1759-5029 (ISSN-L)
1759-5037
DOI: 10.1038/nrendo.2014.102
OpenAlex: W1996079534
Cited by: 196
References: 189
Citations by year: 2026: 11 · 2025: 14 · 2024: 22 · 2023: 16 · 2022: 14 · 2021: 14 · 2020: 14 · 2019: 16 · 2018: 16 · 2017: 19 · 2016: 14 · 2015: 24 · 2014: 1 · 2013: 1
FWCI: 3.03
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: Nature Reviews Endocrinology (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute for Health and Care Research (CL-2009-21-004)
Academy of Medical Sciences (AMS-SGCL5-Jayasena)
European Society of Human Reproduction and Embryology
Topics: Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords: polycystic ovary syndrome, hyperandrogenism, hirsutism, menstrual irregularity, infertility, insulin resistance, obesity, type 2 diabetes, cardiometabolic risk, antiandrogen therapy, ovulation induction, metformin, impaired glucose tolerance, lifestyle intervention, pathophysiology, etiology
MeSH terms: Androgen Antagonists, Androgens, Animals, Diabetes Mellitus, Type 2, Female, Hirsutism, Humans, Insulin Resistance, Polycystic Ovary Syndrome, Disease Management, Risk Reduction Behavior

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