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Contemporary medical therapy for polycystic ovary syndrome
Author(s) -
Lanham M.S.M.,
Lebovic D.I.,
Domino S.E.
Publication year - 2006
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2006.08.004
Subject(s) - medicine , polycystic ovary , hyperandrogenism , metformin , endocrinology , anovulation , ovulation induction , hirsutism , pioglitazone , aromatase inhibitor , gynecology , ovulation , insulin resistance , aromatase , insulin , type 2 diabetes , diabetes mellitus , hormone , breast cancer , cancer
Polycystic ovary syndrome is a multi‐system endocrinopathy with long‐term metabolic and cardiovascular health consequences. Patients typically present due to symptoms of irregular menstruation, hair growth, or infertility; however, recent management options are aimed at further treating underlying glucose–insulin abnormalities as well as androgen excess for proactive control of symptoms. By a 2003 international consensus conference, diagnosis is made by two out of three criteria: chronic oligoovulation or anovulation after excluding secondary causes, clinical or biochemical evidence of hyperandrogenism (but not necessarily hirsutism due to inter‐patient variability in hair follicle sensitivity), and radiological evidence of polycystic ovaries. Traditional medical treatment options include oral contraceptive pills, cyclic progestins, ovulation induction, and anti‐androgenic medications (aldosterone antagonist, 5α‐reductase antagonist, and follicle ornithine decarboxylase inhibitor). Recent pharmacotherapies include insulin‐sensitizing medications metformin and two thiazolidinediones (rosiglitazone/Avandia® and pioglitazone/Actos®), a CYP19 aromatase inhibitor (letrozole/Femara®), and statins to potentially lower testosterone levels.