The pathogenesis and treatment of polycystic ovary syndrome: What’s new?
Open accessAbstract
Polycystic ovary syndrome (PCOS) is currently the leading cause of menstrual complications in women. It is characterized by clinical and/or biochemical hyperandrogenism, ovulation abnormalities and the presence of enlarged and/or polycystic ovaries in ultrasound images (12 or more small bubbles located circumferentially and/or ovarian volume > 10 mL). It is often comorbid with hyperinsulinemia, dyslipidemia, overweight or obesity, and is a risk factor for the development of diabetes and cardiovascular diseases (CVDs). The treatment of patients with PCOS depends on the prevailing symptoms. The aim of this paper is to present the etiopathogenesis, clinical and biochemical implications, and non-pharmacological and pharmacological treatment options - those approved by worldwide scientific organizations as well as new therapies whose initial results are encouraging enough to prompt researchers to explore them further.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The pathological mechanism by which PCOS arises is very complex, multifactorial and still remains largely unclear, but appears to be a disbalance in hormones, androgens and insulin in particular.
“The pathological mechanism by which PCOS arises is very complex, multifactorial and still remains largely unclear, but appears to be a disbalance in hormones, androgens and insulin in particular [189].”
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 [189]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Lifestyle Modification Programs in Polycystic Ovary Syndrome: Systematic Review and Meta-Analysis
Domecq, J. P., Prutsky, G., Mullan, R. J., Hazem, A., Sundaresh, V., Elamin, M. B., Phung, O. J., Wang, A., Hoeger, K., Pasquali, R., et al. (2013) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.2013-2385 · Cited by 184 · see citing works
Du, Q., Yang, S., Wang, Y.-J., Wu, B., Zhao, Y.-Y., & Fan, B. (2012) · Advances in Therapy · doi:10.1007/s12325-012-0044-6 · Cited by 47 · see citing works
Flagged first, then by citations
Research works printed but not linked: 42
- Wołczyński S, Zgliczyński W. Abnormalities of the menstrual cycle. In: Large Interna -Endocrinology. 2 nd edition. Medical Tribune Poland, Warsaw 2012, 561-567.
- The Rotterdam ESHRE/ASRM-sponsored PCOS consensus work- shop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19(1):41-47. doi: 10.1093/humrep/deh098. · DOI · Paper page
- Milewicz A. Reimbursement of metformin for polycystic ovary syn- drome. Endokrynol Pol. 2013;64(5):409-414. doi: 10.5603/EP.2013.0025. · DOI
- Morotti E, Battaglia B, Fabbri R, Paradisi R, Venturoli S, Battaglia C. Cigarette smoking and cardiovascular risk in young women with polycystic ovary syndrome. Int J Fertil Steril. 2014;7(4):301-312. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3901187 [Published online 2013 Dec 22].
- Davies MJ, Marino JL, Willson KJ, March WA, Moore VM. Intergenera- tional associations of chronic disease and polycistic ovary syndrome. PLoS One. 2011;6(10):e25947. doi: 10.1371/journal.pone. 0025947. · DOI
- Tan S, Scherag A, Janssen OE et al. Large effects on body mass index and insulin resistance women with PCOS (FTO) variants in patients with polycystic ovary syndrome (PCOS). BMC Med Genet. 2010;11:12. doi: 10.1186/1471-2350-11-12. · DOI
- Fica S, Albu A, Constantin M, Dobri GA, Davila C. Insulin resistance and fertility in polycystic ovary syndrome. J Med Life. 2008;1(4):415- 422. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3018970/ Pub- lished online 2008 Nov 25.
- Traub ML. Assessing and treating insulin resistance in women with polycystic ovarian syndrome. World J Diabetes. 2011;2(3):33-40. doi: 10.4239/wjd.v2.i3.33. · DOI
- Sathyapalan T, Atkin ST. Mediators of inflammation in polycystic ovary syndrome in relation to adiposity. Mediat Inflamm. 2010;2010: 758656. doi: 10.1155/2010/758656. · DOI
- McClung J, Karl P. Iron deficiency and obesity: The contribution of inflammation and diminished iron absorption. Nutr Rev. 2009;67: 100-104. doi: 10.1111/j.1753-4887.2008.00145.x. · DOI · Paper page
- Bentley-Lewis R, Selly E, Dunaif A. Ovarian hypertension: Polycystic ovary syndrome. Endocrinol Metab Clin North Am. 2011;40:433-449. doi: 10.1016/j.ecl.2011.01.009. · DOI
- Krępuła K, Bidzińska-Speichert B, Lenarcik A, Tworowska-Bardziń- ska U. Psychiatric disorders related to polycystic ovary syndrome. Pol J Endocrinol. 2012;63(6):488-491.
- Dumesic DA, Lobo RA. Cancer risk and PCOS. Steroids. 2013;78(8): 782-785. doi: 10.1016/j.steroids.2013.04.004. · DOI
- Stovall DW, Bailey AP, Pastore LM. Assessment of insulin resistance and impaired glucose tolerance in lean women with polycystic ovary syndrome. J Womens Health. 2011;20(1):37-43. doi: 10.1089/ jwh.2010.2053. · DOI
- Sidhwani S, Scoccia B, Sunghay A, Stephens-Archer CN, Mazzone T, Sam S. PCOS is associated with atherogenic changes in lipoprotein particle number and size independent of body weight. Clin Endo- crinol. 2011;75:76-82. doi: 10.1111/j.1365-2265.2011.04015.x. · DOI
- Bu Z, Kuok K, Meng J, Wang R, Xu B, Zhang H. The relationship between polycystic ovary syndrome, glucose tolerance status and serum preptin level. Reprod Biol Endocrine. 2012;10:10. doi: 10.1186/ 1477-7827-10-10. · DOI
- Kahal H, Atkin SL, Sathyapalan T. Pharmacological treatment of obesity in patients with polycystic ovary syndrome. J Obes. 2011: 402052. doi: 10.1155/2011/402052. · DOI
- Beck E, Scheen AJ. Metformin, an antidiabetic molecule with anti- cancer properties. Rev Med Liege. 2013;68(9):444-449.
- Chung HH, Moon JS, Yoon JS, Lee HW, Won KC. The relationship between metformin and cancer in patients with type 2 diabetes. Diabetes Metab J. 2013;37(2):125-131. doi: 10.4093/dmj.2013. 37.2.125. · DOI
- Badr D, Kurban M, Abbas O. Metformin in dermatology: An over- view. J Eur Acad Dermatol Venereol. 2013;Nov, 27:1329-1335. doi: 10.1111/jdv.12116. · DOI
- Tang T, Glanville J, Hayden CJ, White D, Barth JH, Balen AH. Com- bined lifestyle modification and metformin in obese patients with polycystic ovary syndrome: A randomized, placebo-controlled, double-blind multicentre study. Hum Reprod. 2006;21:80-89. doi: 10.1093/humrep/dei311. · DOI · Paper page
- Oppelt PG, Mueller A, Jentsch K, et al. The effect of metformin treatment for 2 years without caloric restriction on endocrine and metabolic parameters in women with polycystic ovary syndrome. Exp Clin Endocrinol Diabetes. 2010;118:633-637. doi: 10.1055/s-0029- 1237705. · DOI
- Malik SM, Traub M. Defining the role of bariatric surgery in poly- cystic ovarian syndrome patients. World J Diabetes. 2012;3(4):71-79. doi: 10.4239/wjd.v3.i4.71. · DOI
- Wolf JE, Shander D, Huber F, et al. Randomized, double-blind clini- cal evaluation of the efficacy and safety of topical eflornithine HCl 13.9% cream in the treatment of women with facial hair. Int J Der- matol. 2007;46:94-99. doi: 10.1111/j.1365-4632.2006.03079.x. · DOI
- Cakir GA, Erdogan FG, Gurler A. Isotretinoin treatment in nodulo- cystic acne with and without polycystic ovary syndrome: Efficacy and determinants of relapse. Int J Dermatol. 2013;Mar;52(3):371- 376. doi: 10.1111/j.1365-4632.2012.05691.x. · DOI
- Çetinözman F, Yazgan AD, Elçin G, Yildiz BO. Insulin sensitivity, andro- gens and isotretinoin therapy in women with severe acne. J Derma- tolog Treat. 2014;25(2):119-122. doi: 10.3109/09546634.2012.751482. · DOI
- Vexiau P, Chaspoux C, Boudou P, et al. Effects of minoxidil 2% vs. cyproterone acetate treatment on female androgenetic alope- cia: A controlled, 12-month randomized trial. Br J Dermatol. 2002, 146(6):992-999. doi: 10.1046/j.1365-2133.2002.04798.x. · DOI
- Vinaixa M, Rodriguez MA, Samino S et al. Metabolomics reveals reduction of metabolic oxidation in women with polycystic ovary syndrome after pioglitazone-flutamide-metformin polytherapy. PLoS One. 2011;6(12):e29052. doi: 10.1371/journal.pone.0029052. · DOI
- Jensterle Sever M, Kocjan T, Pfeifer M, Kravos NA, Janez A. Short- term combined treatment with liraglutide and metformin leads to significant weight loss in obese women with polycystic ovary syn- drome and previous poor response to metformin. Eur J Endocrinol. 2014;170(3):451-459. doi: 10.1530/EJE-13-0797. · DOI · Paper page
- Thomson RL, Spedding S, Brinkworth GD, Noakes M, Buckley JD. Seasonal effects on vitamin D status influence outcomes of life- style intervention in overweight and obese women with polycys- tic ovary syndrome. Fertil Steril. 2013;99(6):1779-1785. doi: 10.1016/j. fertnstert.2012.12.042. · DOI
- Celik O, Acbay O. Effects of metformin plus rosuvastatin on hyper- androgenism in polycystic ovary syndrome patients with hyper- lipidemia and impaired glucose tolerance. J Endocrinol Invest. 2012;35(10):905-910. doi: 10.3275/8371. · DOI
- Sathyapalan T, Shepherd J, Coady AM, Kilpatrick ES, Atkin SL. Ator- vastatin reduces malondialdehyde concentrations in patients with polycystic ovary syndrome. J Clin Endocrinol Metab. 2012;97(11): 3951-3955. doi: 10.1210/jc.2012-2279. · DOI
- Kimura Y, Hyogo H, Yamagishi S, et al. Atorvastatin decreases serum levels of advanced glycation endproducts (AGEs) in nonalcoholic steatohepatitis (NASH) patients with dyslipidemia: Clinical useful- ness of AGEs as a biomarker for the attenuation of NASH. J Gastro- enterol. 2010;45(7):750-757. doi: 10.1007/s00535-010-0203-y. · DOI
- Macut D, Bjekić-Macut J, Savić-Radojević A. Dyslipidemia and oxi- dative stress in PCOS. Front Horm Res. 2013;40:51-63. doi: 10.1159/ 000341683. · DOI
- Salehpour S, Tohidi M, Akhound MR, Amirzargar N. N-acetylcys- teine: A novel remedy for polycystic ovarian syndrome. Int J Fertil Steril. 2009,3:66-73. https://www.researchgate.net/publication/ 228674382_N_Acetyl_Cysteine_A_novel_Remedy_for_Poly_Cystic_ Ovarian_Syndrome. Accessed 23 Aug 2009.
- Lansdown A, Rees DA. The sympathetic nervous system in poly- cystic ovary syndrome: A novel therapeutic target? Clin Endocrinol (Oxf). 2012;77(6):791-801. doi: 10.1111/cen.12003. · DOI
- Schlaich MP, Straznicky N, Grima M, et al. Renal denervation: A poten- tial new treatment modality for polycystic ovary syndrome? J Hy- pertens. 2011;29(5):991-996. doi: 10.1097/HJH.0b013e328344db3a. · DOI
- Katoh M. FGFR2 abnormalities underlie a spectrum of bone, skin, and cancer pathologies. J Invest Dermatol. 2009;129:1861-1867. doi: 10.1038/jid.2009.97. · DOI
- Kharitonenkov A, Adams AC. Inventing new medicines: The FGF21 story. Mol Metab. 2014;3:221-229. doi: 10.1016/j.molmet.2013.12. 003. · DOI
- Unfer V, Carlomagno G, Dante G, et al. Effects of myo-inositol in women with PCOS: A systematic review of randomized con- trolled trials. Gynecol Endocrinol. 2012;28(7):509-515. doi: 10.3109/ 09513590.2011.650660. · DOI · Paper page
- Erin Barthelmess Rajesh KN. Polycystic ovary syndrome: Current status and future perspective. Front Biosci. 2014;6:104-119. https:// www.ncbi.nlm.nih.gov/pmc/articles/PMC4341818/. Published online 2014 Jan 1.
- Sunita J. Ramanand, Balasaheb B. Ghongane, Jaiprakash B. Rama- nand, et al. Clinical characteristics of polycystic ovary syndrome in Indian women. Indian J Endocrinol Metab. 2013;17(1):138-145. doi: 10.4103/2230-8210.107858. · DOI
Cited by
Sorted by citations
Polycystic Ovary Syndrome: A Comprehensive Review of Pathogenesis, Management, and Drug Repurposing
Sadeghi, H. M., Adeli, I., Calina, D., Docea, A. O., Mousavi, T., Daniali, M., Nikfar, S., Tsatsakis, A., & Abdollahi, M. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23020583 · Cited by 445 · see citing works
Qu, X., & Donnelly, R. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21218191 · Cited by 210 · see citing works
Narinx, N., David, K., Walravens, J., Vermeersch, P., Claessens, F., Fiers, T., Lapauw, B., Antonio, L., & Vanderschueren, D. (2022) · Cellular and Molecular Life Sciences · doi:10.1007/s00018-022-04562-1 · Cited by 96 · see citing works
PCOS and nutritional approaches: Differences between lean and obese phenotype
Barrea, L., Frias-Toral, E., Verde, L., Ceriani, F., Cucalón, G., Garcia-Velasquez, E., Moretti, D., Savastano, S., Colao, A., & Muscogiuri, G. (2021) · Metabolism Open · doi:10.1016/j.metop.2021.100123 · Cited by 86 · see citing works
Insulin Resistance and Serum Magnesium Concentrations among Women with Polycystic Ovary Syndrome
Hamilton, K. P., Zelig, R., Parker, A. R., & Haggag, A. (2019) · Current Developments in Nutrition · doi:10.1093/cdn/nzz108 · Cited by 41 · see citing works
Tosatti, J. A. G., Alves, M. T., Cândido, A. L., Reis, F. M., Araújo, V. E., & Gomes, K. B. (2021) · British Journal of Nutrition · doi:10.1017/s0007114520003207 · Cited by 38 · see citing works
Calcaterra, V., Magenes, V. C., Massini, G., De Sanctis, L., Fabiano, V., & Zuccotti, G. (2024) · Nutrients · doi:10.3390/nu16070938 · Cited by 35 · see citing works
Calcaterra, V., Cena, H., Sottotetti, F., Hruby, C., Madini, N., Zelaschi, N., & Zuccotti, G. (2023) · Nutrients · doi:10.3390/nu15163582 · Cited by 27 · see citing works
“Reports on the epidemiology of PCOS in adolescents are rare, and evaluation of its prevalence in adolescents may be difficult because of the high prevalence of paraphysiologic ovulatory dysfunction and of the common echographic finding of micropolycystic ovaries in this population; prevalence data depend on which diag…”
BackgroundAmirkhizi, F., Taghizadeh, M., Hamedi-Shahraki, S., & Asghari, S. (2025) · Nutrition & Metabolism · doi:10.1186/s12986-025-00932-1 · Cited by 3 · see citing works
“This condition presents with various clinical and metabolic manifestations including hyperandrogenism, obesity, glucose intolerance, hirsutism, acne, and raised androgens with irregular menses and infertility [3].”
- Authors
- Bednarska, S., & Siejka, A.
- Affiliations
- Medical University of Lodz (PL)
- Venue
- Advances in Clinical and Experimental Medicine
- Publisher
- Wroclaw Medical University
- Published
- 2017-04-27
- Volume
- 26
- Issue
- 2
- Pages
- 359-367
- ISSN
- 1899-5276 (ISSN-L)
- OpenAlex
- W2622617837
- Cited by
- 284
- References
- 2
- Citations by year
- 2026: 18 · 2025: 22 · 2024: 63 · 2023: 50 · 2022: 53 · 2021: 35 · 2020: 22 · 2019: 13 · 2018: 8
- FWCI
- 1.92
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Advances in Clinical and Experimental Medicine (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Biology and Fertility
- Keywords
- polycystic ovary syndrome, hyperandrogenism, ovulatory dysfunction, hyperinsulinemia, dyslipidemia, obesity, diabetes risk, cardiovascular risk, PCOS pathogenesis, PCOS treatment, non-pharmacological treatment, pharmacotherapy, new drugs
- MeSH terms
- Cardiovascular Diseases, Diabetes Mellitus, Drug Therapy, Combination, Female, Humans, Inflammation, Models, Biological, Obesity, Polycystic Ovary Syndrome, Risk Factors
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
