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Cited by 143Ovarian function and disordersEndometriosis Research and TreatmentReproductive Biology and Fertility

The DOI matches its Crossref record; 73 of the 73 references it cites were found in a registry or an index.

Recent advances in the understanding and management of polycystic ovary syndrome

Open access
Rocha, Ana L., Oliveira, Flávia R., Azevedo, Rosana C., Silva, Virginia A., Peres, Thais M., Candido, Ana L., Gomes, Karina B., Reis, Fernando M.·2019·F1000Research
DOI 10.12688/f1000research.15318.1PMC PMC6489978
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Abstract

Polycystic ovary syndrome (PCOS) is a multifaceted condition characterized by chronic anovulation and excess ovarian activity, in contrast to other causes of anovulation that involve ovarian dormancy or primary insufficiency. Recent studies indicated that PCOS is associated with low-grade chronic inflammation and that women with PCOS are at increased risk of non-alcoholic fatty liver disease. The inflammatory and metabolic derangements associated with PCOS are explained in part by the coexistence of insulin resistance and obesity but are further fueled by the androgen excess. New insights into the regulation of hormones and cytokines in muscle and fat tissue support the concept that PCOS is a systemic syndrome. The therapeutic plan should be tailored to the patient phenotype, complaints, and reproductive desire. Of note, the aromatase inhibitor letrozole seems to be more effective than the reference drug clomiphene citrate to treat infertility due to PCOS. Integral management by a multidisciplinary team may help the patients to adhere to lifestyle interventions and thereby reduce body adiposity and recover their metabolic and reproductive health.

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Figure 1. Schematic representation of some pathophysiological mechanisms of polycystic ovary syndrome. The main clinical manifestations are shown in rectangular boxes. Androgens are responsible for dermatological symptoms, while sustained estrogen production by the ovaries and subcutaneous fat without progesterone opposition produces menstrual irregularity and increases the risk of endometrial hyperplasia. Adipokines and myokines may also be involved in the metabolic alterations associated with the syndrome. Insulin resistance and the compensatory hyperinsulinemia are central mechanisms that perpetuate anovulation and lead to metabolic complications. AMH, anti-Müllerian hormone; FSH, follicle-stimulating hormone; IGF-I, insulin-like growth factor I; LH, luteinizing hormone; NAFLD, non-alcoholic fatty liver disease; SHBG, sex hormone–binding globulin.
Figure 1. Schematic representation of some pathophysiological mechanisms of polycystic ovary syndrome. The main clinical manifestations are shown in rectangular boxes. Androgens are responsible for dermatological symptoms, while sustained estrogen production by the ovaries and subcutaneous fat without progesterone opposition produces menstrual irregularity and increases the risk of endometrial hyperplasia. Adipokines and myokines may also be involved in the metabolic alterations associated with the syndrome. Insulin resistance and the compensatory hyperinsulinemia are central mechanisms that perpetuate anovulation and lead to metabolic complications. AMH, anti-Müllerian hormone; FSH, follicle-stimulating hormone; IGF-I, insulin-like growth factor I; LH, luteinizing hormone; NAFLD, non-alcoholic fatty liver disease; SHBG, sex hormone–binding globulin.CC BY · PubMed Central
Figure 2. Patient-centered care by a multidisciplinary team may help reach the main goals of polycystic ovary syndrome management. These goals are symptom relief, safe fertility planning, general well-being, and prevention of long-term complications.
Figure 2. Patient-centered care by a multidisciplinary team may help reach the main goals of polycystic ovary syndrome management. These goals are symptom relief, safe fertility planning, general well-being, and prevention of long-term complications.CC BY · PubMed Central
Figure 3. Objectives of assessing the quality of life in women with polycystic ovary syndrome.
Figure 3. Objectives of assessing the quality of life in women with polycystic ovary syndrome.CC BY · PubMed Central

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Metadata

Authors
Rocha, A. L., Oliveira, F. R., Azevedo, R. C., Silva, V. A., Peres, T. M., Candido, A. L., Gomes, K. B., & Reis, F. M.
Affiliations
Universidade Federal de Minas Gerais (BR)
ORCID
Venue
F1000Research
Publisher
F1000 Research Ltd
Published
2019-04-26
Volume
8
Pages
565
ISSN
2046-1402 (ISSN-L)
DOI
10.12688/f1000research.15318.1
PMC
PMC6489978
OpenAlex
W2940491682
Cited by
142
References
73
Citations by year
2026: 7 · 2025: 24 · 2024: 22 · 2023: 30 · 2022: 29 · 2021: 18 · 2020: 9 · 2019: 2
FWCI
2.05
Type
journal article
Language
en
Open access
Licence
Locations
  • F1000Research (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Conselho Nacional de Desenvolvimento Científico e Tecnológico
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
  • Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
  • Health Sciences › Medicine › Reproductive Medicine › Reproductive Biology and Fertility
Keywords
polycystic ovary syndrome, anovulation, low-grade inflammation, non-alcoholic fatty liver disease, insulin resistance, obesity, hyperandrogenism, systemic inflammation, letrozole, clomiphene citrate, multidisciplinary management, lifestyle intervention, adiposity
MeSH terms
Letrozole, Clomiphene, Female, Humans, Insulin Resistance, Obesity, Polycystic Ovary Syndrome, Aromatase Inhibitors

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