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The Management of Polycystic Ovary Syndrome
Author(s) -
BRUNI VINCENZA,
DEI METELLA,
PONTELLO VALENTINA,
VANGELISTI PAOLO
Publication year - 2003
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1196/annals.1290.034
Subject(s) - polycystic ovary , ovary , medicine , gynecology , insulin , insulin resistance
A bstract : It is well known that subjects with polycystic ovary syndrome (PCOS) show very variable clinical and biochemical aspects. Considering long‐term repercussions, two main disturbances, not always strictly related, need to be countered: hyperandrogenism and insulin resistance, with compensatory hyperinsulinemia. The aim of this review is to summarize therapeutic perspectives for PCOS, starting from basic approach, such as weight reduction and changes in lifestyle. The benefits of long‐term use of oral contrceptives and the criteria of choice of the estro‐progestin combinations are discussed. With severe hyperandogenism, a pure antiandrogen should be added. The experiences with insulin‐sensitizing drugs, especially metformin, are reviewed; while their beneficial role as an adjuvant to treatment of ovulatory infertility has been well established, the effects of a long‐term treatment, especially in very young patients, are still under debate. Current studies are testing the results of combinations of different treatments at low dosage; randomized comparative trials on the long‐term efficacy of these approaches have yet to be scheduled.