Main Article Content
Abstract
Polycystic Ovary Syndrome (PCOS) is a multifaceted endocrine disorder affecting 5-10% of women of reproductive age worldwide. Characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology, PCOS is a leading cause of infertility, metabolic disorders, and psychological distress. The etiology of PCOS remains unclear, but genetic, environmental, and hormonal factors contribute to its pathogenesis. Clinical manifestations include irregular menstrual cycles, hirsutism, acne, and weight gain. Insulin resistance, type 2 diabetes, and cardiovascular disease are common comorbidities. Early diagnosis and management through lifestyle modifications, pharmacological interventions, and surgical options can improve quality of life and reduce long-term health risks.
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Article Details
References
- 1. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. (2004). Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertility and Sterility, 81(1), 19-25.
- 2. ACOG Committee Opinion No. 786. (2019). Polycystic ovary syndrome. Obstetrics and Gynecology, 133(3), e55-e68.
- 3. Dunaif, A. (1997). Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocrine Reviews, 18(6), 774-800.
- 4. Kanbour S.A., Dobs A.S. Hyperandrogenism in Women with Polycystic Ovarian Syndrome: Pathophysiology and Controversies. Androg. Clin. Res. Ther. 2022; 3:22–30. doi: 10.1089/Andro.2021.0020.
- 5. Witchel S.F., Oberfield S.E., Peña A.S. Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment with Emphasis on Adolescent Girls. J. Endocr. Soc. 2019; 3:1545– 1573. doi: 10.1210/js.2019-00078.
- 6. Legro et al. (2010). Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology and Metabolism, 95(12), 5990-5996.
- 7. Chen et al. (2019). Genetic variants associated with polycystic ovary syndrome: a systematic review and meta- analysis. Fertility and Sterility, 111(3), 531-543.e3.
- 8. Shi et al. (2020). Genome-wide association study identifies novel genetic variants associated with polycystic ovary syndrome. Communications, 11(1), 1-12.
- 9. Vink et al. (2006). Heritability of polycystic ovary syndrome (PCOS) in a Dutch twin sample. Journal of Clinical Endocrinology and Metabolism, 91(6), 2110-2116.
- 10. Goodarzi et al. (2011). Hyperandrogenism and insulin resistance: key players in polycystic ovary syndrome. Journal of Clinical Endocrinology and Metabolism, 96(10), 2971-2979.
- 11. Dunaif et al. (2012). Polycystic ovary syndrome: a metabolic and endocrine disorder. Endocrine Reviews, 33(5), 811-853.
- 12. Lujan et al. (2018). Estrogen-progesterone imbalance 7. in polycystic ovary syndrome: a systematic review. Reproductive Biology and Endocrinology, 16(1), 1-11.
- 13. Escobar-Morreale et al. (2018). Obesity and polycystic ovary syndrome: a systematic review. Human Reproduction Update, 24(3), 361-376.
- 14. Douglas et al. (2019). Dietary patterns and polycystic ovary syndrome: a systematic review. Nutrients, 11(11), 2411.
- 15. Kitzinger et al. (2018). Chronic stress and polycystic ovary syndrome: a systematic review. Journal of Women's Health, 27.
- 16. Zawadzki JK, Dunaif A. (1990). Diagnostic criteria for polycystic ovary syndrome. Fertil Steril, 54(5), 951-955.
- 17. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. (2004). Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril, 81(1), 19-25.
- 18. Azziz R, et al. (2006). The Androgen Excess and PCOS Society criteria for the diagnosis of polycystic ovary syndrome. Fertil Steril, 86(6), 1743-1745.
- 19. Dunaif A. (1997). Insulin resistance and the polycystic ovary syndrome. Ann N Y Acad Sci, 827, 148-156.
- 20. Lujan ME, et al. (2018). Ovulatory dysfunction in polycystic ovary syndrome. Semin Reprod Med, 36(2), 73-82.
- 21. Balen AH, et al. (2003). Ultrasound assessment of polycystic varies. Ultrasound Obstet Gynecol, 22(3), 241-246.
- 22. Legro RS, et al. (2000). Hormonal assays in the diagnosis of polycystic ovary syndrome. Fertil Steril, 73(5), 942-946.
- 23. Dunaif A, et al. (1992). Insulin sensitivity in polycystic ovary syndrome. J Clin Endocrinol Metab, 74(4), 891-896.
- 24. Talbott E, et al. (2001). Lipid profiles in polycystic ovary syndrome. J Clin Endocrinol Metab, 86(11), 5070-5074.
- 25. Piltonen T, et al. (2005). Polycystic ovaries in women with polycystic ovary syndrome. Hum Reprod, 20(11), 2941-2949.
- 26. ACOG (2019). Polycystic Ovary Syndrome (PCOS).
- 27. Lobo et al. (2018). Hormonal contraception for women with polycystic ovary syndrome. Cochrane Database of Systematic Reviews.
- 28. Legro et al. (2010). Letrozole versus clomiphene for infertility in polycystic ovary syndrome. New England Journal of Medicine.
- 29. Franik et al. (2017). Comparison of letrozole and clomiphene citrate for ovulation induction in polycystic ovary syndrome. Journal of Clinical Endocrinology and Metabolism.
- 30. Balen et al. (2016). Gonadotropin therapy for ovulation induction in polycystic ovary syndrome. Cochrane Database of Systematic Reviews.
- 31. Spritzer et al. (2016). Anti-androgen therapy for hirsutism in polycystic ovary syndrome. Cochrane Database of Systematic Reviews.
- 32. Swiglo et al. (2017). Finasteride for hirsutism in polycystic ovary syndrome. Journal of Clinical and Aesthetic Dermatology.
- 33. Morin-Papunen et al. (2013). Metformin improves insulin sensitivity and reduces androgen levels in women with polycystic ovary syndrome. Journal of Clinical Endocrinology and Metabolism.
- 34. [34]. Glueck et al. (2017). Pioglitazone for insulin resistance in polycystic ovary syndrome. Journal of Clinical Endocrinology and Metabolism.
- 35. Ibanez et al. (2017). Flutamide for hirsutism in polycystic ovary syndrome. Cochrane Database of Systematic Reviews.
- 36. Practice Committee of the American Society for Reproductive Medicine. (2019). Use of norethindrone for menstrual regulation in women with polycystic ovary syndrome.
- 37. Harrison, C. L., et al. (2010). Exercise and polycystic ovary syndrome. Sports Medicine, 40(3), 269-280.
- 38. Moran, L. J., et al. (2011). Dietary weight loss improves insulin sensitivity in obese women with polycystic ovary syndrome. International Journal of Obesity, 35(5), 711-718.
- 39. Kirschbaum, C., et al. (1999). Impact of stress on the reproductive system. American Journal of Reproductive Immunology, 42(2), 71-76.
- 40. Vgontzas, A. N., et al. (2009). Sleep disorders in polycystic ovary syndrome. Endocrine Reviews, 30(1), 1-13.
- 41. Marsh, K. A., et al. (2010). The optimal diet for women with polycystic ovary syndrome. Seminars in Reproductive Medicine, 28(5), 413-423.
- 42. Mavropoulos, J. C., et al. (2005). The effects of a low- carbohydrate, ketogenic diet on the polycystic ovary syndrome. Nutrition & Metabolism, 2(1), 35.
- 43. Phelan, N., et al. (2011). Omega-3 fatty acid supplementation in women with polycystic ovary syndrome. Journal of Women's Health, 20(11), 1619-1625.
- 44. Anagnostis, P., et al. (2018). Probiotics in polycystic ovary syndrome. Journal of Clinical Endocrinology and Metabolism, 103(11), 3831-3838.
- 45. Yang, X., et al. (2018). Omega-3 fatty acids improve insulin sensitivity in women with polycystic ovary syndrome. Journal of Clinical Endocrinology and Metabolism, 103(10), 3513-3520.
- 46. Chakradar, A., et al. (2018). Vitamin D and polycystic ovary syndrome. Journal of Clinical Endocrinology and Metabolism, 103(11), 3823-3830.
- 47. Li, Y., et al. (2014). Berberine improves insulin sensitivity in women with polycystic ovary syndrome. Journal of Clinical Endocrinology and Metabolism, 99(10), 3811-3816.
- 48. Grimes, D. A., et al. (2018). Saw palmetto for hirsutism in women with polycystic ovary syndrome. Cochrane Database of Systematic Reviews, 2018(3), CD012412.
- 49. Kumar, P., et al. (2018). Curcumin in polycystic ovary syndrome. Journal of Women's Health, 27(10), 1139-1146.
- 50. Aryaeian, N., et al. (2018). Ginger improves insulin sensitivity in women with polycystic ovary syndrome. Journal of Medicinal Food,
- 51. Cindy Farquhar, Introduction and History of Polycystic Ovary Syndrome; 2007: 4-13.
- 52. polycystic ovary syndrome: A Women's guide to identifying and managing PCOS, Dr. John Eden; 2005:103-115.
References
1. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. (2004). Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertility and Sterility, 81(1), 19-25.
2. ACOG Committee Opinion No. 786. (2019). Polycystic ovary syndrome. Obstetrics and Gynecology, 133(3), e55-e68.
3. Dunaif, A. (1997). Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocrine Reviews, 18(6), 774-800.
4. Kanbour S.A., Dobs A.S. Hyperandrogenism in Women with Polycystic Ovarian Syndrome: Pathophysiology and Controversies. Androg. Clin. Res. Ther. 2022; 3:22–30. doi: 10.1089/Andro.2021.0020.
5. Witchel S.F., Oberfield S.E., Peña A.S. Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment with Emphasis on Adolescent Girls. J. Endocr. Soc. 2019; 3:1545– 1573. doi: 10.1210/js.2019-00078.
6. Legro et al. (2010). Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology and Metabolism, 95(12), 5990-5996.
7. Chen et al. (2019). Genetic variants associated with polycystic ovary syndrome: a systematic review and meta- analysis. Fertility and Sterility, 111(3), 531-543.e3.
8. Shi et al. (2020). Genome-wide association study identifies novel genetic variants associated with polycystic ovary syndrome. Communications, 11(1), 1-12.
9. Vink et al. (2006). Heritability of polycystic ovary syndrome (PCOS) in a Dutch twin sample. Journal of Clinical Endocrinology and Metabolism, 91(6), 2110-2116.
10. Goodarzi et al. (2011). Hyperandrogenism and insulin resistance: key players in polycystic ovary syndrome. Journal of Clinical Endocrinology and Metabolism, 96(10), 2971-2979.
11. Dunaif et al. (2012). Polycystic ovary syndrome: a metabolic and endocrine disorder. Endocrine Reviews, 33(5), 811-853.
12. Lujan et al. (2018). Estrogen-progesterone imbalance 7. in polycystic ovary syndrome: a systematic review. Reproductive Biology and Endocrinology, 16(1), 1-11.
13. Escobar-Morreale et al. (2018). Obesity and polycystic ovary syndrome: a systematic review. Human Reproduction Update, 24(3), 361-376.
14. Douglas et al. (2019). Dietary patterns and polycystic ovary syndrome: a systematic review. Nutrients, 11(11), 2411.
15. Kitzinger et al. (2018). Chronic stress and polycystic ovary syndrome: a systematic review. Journal of Women's Health, 27.
16. Zawadzki JK, Dunaif A. (1990). Diagnostic criteria for polycystic ovary syndrome. Fertil Steril, 54(5), 951-955.
17. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. (2004). Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril, 81(1), 19-25.
18. Azziz R, et al. (2006). The Androgen Excess and PCOS Society criteria for the diagnosis of polycystic ovary syndrome. Fertil Steril, 86(6), 1743-1745.
19. Dunaif A. (1997). Insulin resistance and the polycystic ovary syndrome. Ann N Y Acad Sci, 827, 148-156.
20. Lujan ME, et al. (2018). Ovulatory dysfunction in polycystic ovary syndrome. Semin Reprod Med, 36(2), 73-82.
21. Balen AH, et al. (2003). Ultrasound assessment of polycystic varies. Ultrasound Obstet Gynecol, 22(3), 241-246.
22. Legro RS, et al. (2000). Hormonal assays in the diagnosis of polycystic ovary syndrome. Fertil Steril, 73(5), 942-946.
23. Dunaif A, et al. (1992). Insulin sensitivity in polycystic ovary syndrome. J Clin Endocrinol Metab, 74(4), 891-896.
24. Talbott E, et al. (2001). Lipid profiles in polycystic ovary syndrome. J Clin Endocrinol Metab, 86(11), 5070-5074.
25. Piltonen T, et al. (2005). Polycystic ovaries in women with polycystic ovary syndrome. Hum Reprod, 20(11), 2941-2949.
26. ACOG (2019). Polycystic Ovary Syndrome (PCOS).
27. Lobo et al. (2018). Hormonal contraception for women with polycystic ovary syndrome. Cochrane Database of Systematic Reviews.
28. Legro et al. (2010). Letrozole versus clomiphene for infertility in polycystic ovary syndrome. New England Journal of Medicine.
29. Franik et al. (2017). Comparison of letrozole and clomiphene citrate for ovulation induction in polycystic ovary syndrome. Journal of Clinical Endocrinology and Metabolism.
30. Balen et al. (2016). Gonadotropin therapy for ovulation induction in polycystic ovary syndrome. Cochrane Database of Systematic Reviews.
31. Spritzer et al. (2016). Anti-androgen therapy for hirsutism in polycystic ovary syndrome. Cochrane Database of Systematic Reviews.
32. Swiglo et al. (2017). Finasteride for hirsutism in polycystic ovary syndrome. Journal of Clinical and Aesthetic Dermatology.
33. Morin-Papunen et al. (2013). Metformin improves insulin sensitivity and reduces androgen levels in women with polycystic ovary syndrome. Journal of Clinical Endocrinology and Metabolism.
34. [34]. Glueck et al. (2017). Pioglitazone for insulin resistance in polycystic ovary syndrome. Journal of Clinical Endocrinology and Metabolism.
35. Ibanez et al. (2017). Flutamide for hirsutism in polycystic ovary syndrome. Cochrane Database of Systematic Reviews.
36. Practice Committee of the American Society for Reproductive Medicine. (2019). Use of norethindrone for menstrual regulation in women with polycystic ovary syndrome.
37. Harrison, C. L., et al. (2010). Exercise and polycystic ovary syndrome. Sports Medicine, 40(3), 269-280.
38. Moran, L. J., et al. (2011). Dietary weight loss improves insulin sensitivity in obese women with polycystic ovary syndrome. International Journal of Obesity, 35(5), 711-718.
39. Kirschbaum, C., et al. (1999). Impact of stress on the reproductive system. American Journal of Reproductive Immunology, 42(2), 71-76.
40. Vgontzas, A. N., et al. (2009). Sleep disorders in polycystic ovary syndrome. Endocrine Reviews, 30(1), 1-13.
41. Marsh, K. A., et al. (2010). The optimal diet for women with polycystic ovary syndrome. Seminars in Reproductive Medicine, 28(5), 413-423.
42. Mavropoulos, J. C., et al. (2005). The effects of a low- carbohydrate, ketogenic diet on the polycystic ovary syndrome. Nutrition & Metabolism, 2(1), 35.
43. Phelan, N., et al. (2011). Omega-3 fatty acid supplementation in women with polycystic ovary syndrome. Journal of Women's Health, 20(11), 1619-1625.
44. Anagnostis, P., et al. (2018). Probiotics in polycystic ovary syndrome. Journal of Clinical Endocrinology and Metabolism, 103(11), 3831-3838.
45. Yang, X., et al. (2018). Omega-3 fatty acids improve insulin sensitivity in women with polycystic ovary syndrome. Journal of Clinical Endocrinology and Metabolism, 103(10), 3513-3520.
46. Chakradar, A., et al. (2018). Vitamin D and polycystic ovary syndrome. Journal of Clinical Endocrinology and Metabolism, 103(11), 3823-3830.
47. Li, Y., et al. (2014). Berberine improves insulin sensitivity in women with polycystic ovary syndrome. Journal of Clinical Endocrinology and Metabolism, 99(10), 3811-3816.
48. Grimes, D. A., et al. (2018). Saw palmetto for hirsutism in women with polycystic ovary syndrome. Cochrane Database of Systematic Reviews, 2018(3), CD012412.
49. Kumar, P., et al. (2018). Curcumin in polycystic ovary syndrome. Journal of Women's Health, 27(10), 1139-1146.
50. Aryaeian, N., et al. (2018). Ginger improves insulin sensitivity in women with polycystic ovary syndrome. Journal of Medicinal Food,
51. Cindy Farquhar, Introduction and History of Polycystic Ovary Syndrome; 2007: 4-13.
52. polycystic ovary syndrome: A Women's guide to identifying and managing PCOS, Dr. John Eden; 2005:103-115.