Polycystic Ovary Syndrome: A Comprehensive Review of Pathogenesis, Management, and Drug Repurposing

Abstract

Polycystic ovary syndrome (PCOS) is an endocrine-gynecology disorder affecting many women of childbearing age. Although a part of the involved mechanism in PCOS occurrence is discovered, the exact etiology and pathophysiology are not comprehensively understood yet. We searched PubMed for PCOS pathogenesis and management in this article and ClinicalTrials.gov for information on repurposed medications. All responsible factors behind PCOS were thoroughly evaluated. Furthermore, the complete information on PCOS commonly prescribed and repurposed medications is summarized through tables. Epigenetics, environmental toxicants, stress, diet as external factors, insulin resistance, hyperandrogenism, inflammation, oxidative stress, and obesity as internal factors were investigated. Lifestyle modifications and complementary and alternative medicines are preferred first-line therapy in many cases. Medications, including 3-hydroxy-3-methyl-3-glutaryl-coenzyme A (HMG-CoA) reductase inhibitors, thiazolidinediones, sodium-glucose cotransporter-2 inhibitors, dipeptidyl peptidase-4 inhibitors, glucose-like peptide-1 receptor agonists, mucolytic agents, and some supplements have supporting data for being repurposed in PCOS. Since there are few completed clinical trials with a low population and mostly without results on PCOS repurposed medications, it would be helpful to do further research and run well-designed clinical trials on this subject. Moreover, understanding more about PCOS would be beneficial to find new medications implying the effect via the novel discovered routes.

Association between Pre-Pregnancy Overweightness/Obesity and Pregnancy Outcomes in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis

“…Polycystic ovary syndrome (PCOS) affects 4–18% of women of reproductive age, which is characterized by hyperandrogenism, chronic anovulation, and a picture of multiple small follicular cysts in the ovary [ 1 , 2 , 3 , 4 , 5 ]. PCOS is closely linked to metabolic and reproductive disorders, such as obesity, insulin resistance (IR), anovulation-related infertility and a thickened endometrium [ 6 , 7 ].…”

Update on Management of Cardiovascular Diseases in Women

“…Polycystic ovary syndrome (PCOS) includes oligomenorrhea, an excess of androgens, infertility [ 112 ], and insulin resistance (IR) involving 6–10% of all women in the reproductive age [ 113 , 114 ]. Women with PCOS have an increased risk of developing hypertension and diabetes during pregnancy [ 114 ].…”

“…The use of COCs seems to be associated with 2- to 4-fold greater relative risks of arterial and venous thromboembolic events. The risk of venous thromboembolism (VTE) related to COCs therapy in females aged <30 years is estimated to be 3.7/10,000 cases annually compared to 1.2/10,000 in subjects who do not use this therapy, and the risk increases considerably with age [ 114 , 120 ]. Even obese women taking COCs therapy may occur to increased risk of VTE [ 120 ].…”

Клинический Случай Живорождения Дихориальной Триамниотической Тройни После Стимуляции Овуляции Ингибиторами Ароматазы При Синдроме Поликистозных Яичников

“…За последние десять лет были собраны данные многих клинических испытаний, и есть доказательства того, что летрозол может быть так же эффективен, как КЦ, но данные об исходах различаются. ИА похожи по действию на КЦ, вводимые перорально, но из-за короткого периода полувыведения, составляющего 48 часов, ИА оказывают меньше побочных эффектов на ткани-мишени эстрогена, такие как эндометрий и шейка матки, по сравнению с КЦ [7][8][9].…”