Polycystic ovary syndrome: New approaches to treatment (A literary review)
DOI:
https://doi.org/10.37800/RM.3.2025.508Keywords:
Polycystic ovary syndrome , glucagon-like peptide-1 (GLP-1) receptor agonists, antiandrogensAbstract
Relevance: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders among women of reproductive age, leading to hormonal imbalances, metabolic issues, and difficulties with ovulation. This article reviews the latest research since 2020, with a focus on diagnosing, pathogenesis, and modern treatment methods for PCOS. Particular attention is given to new therapeutic approaches, including glucagon-like peptide-1 (GLP-1) receptor agonists, antiandrogens, and nonsteroidal anti-inflammatory drugs (NSAIDs). The article discusses findings that support the effectiveness of these treatments and their roles in improving insulin resistance, reducing hyperandrogenism, and decreasing inflammatory processes.
The study aimed to analyze modern approaches to diagnosing, treating, and preventing polycystic ovary syndrome based on current scientific literature.
Materials and Methods: The review includes sources from PubMed and Google Scholar. Studies published over the past seven years were selected, with an emphasis on clinical guidelines, meta-analyses, and systematic reviews. Epidemiological and molecular aspects of PCOS pathogenesis were also examined.
Results: The current diagnostic criteria for PCOS, adopted in Rotterdam in 2003, include two of the following three features: ovarian cysts, hyperandrogenism, and ovulatory dysfunction. However, recent studies have highlighted the need to revise these criteria. In particular, studies from 2021 have shown that some patients with significant hyperandrogenism and anovulation may not present with cysts, suggesting the need for a more in-depth analysis of hormonal and genetic profiles.
Conclusion: PCOS remains a relevant medical and scientific challenge. Recent studies have revealed new aspects of its pathogenesis, including genetic, metabolic, and inflammatory factors, which enable more accurate therapy selection and the development of preventive strategies. Continued research in this field is crucial for developing more effective and safer treatment methods and enhancing the quality of life for patients with PCOS.
References
1. Лазарева ЛМ, Шарифулин ЭМ, Беленькая ЛВ, Сутурина ЛВ. СПКЯ в репродуктивном возрасте: фенотипическое разнообразие и диагностические подходы (обзор литературы). Доктор.Ру. 2020;19(6):50–56.
Lazareva LM, Sharifulin EM, Belenkaya LV, Suturina LV. PCOS in reproductive age: phenotypic diversity and diagnostic approaches (literature review). Doktor.Ru. 2020;19(6):50-56. Russian.
https://doi.org/10.31550/1727-2378-2020-19-6-50-56
2. Teal S, Edelman A. Contraception Selection, Effectiveness, and Adverse Effects: A Review. JAMA. 2021;326:2507–2518.
https://doi.org/10.1001/jama.2021.21392
3. Грибова ЕА, Потапенко ИВ, Грибов АИ. Метаболический синдром и его роль в развитии сердечно-сосудистых заболеваний у пациентов с мочекаменной болезнью. Урология. 2021;(3):56-63.
Gribova EA, Potapenko IV, Gribov AI. Metabolic syndrome and its role in the development of cardiovascular diseases in patients with urolithiasis. Urologiia. 2021;(3):56-63. Russian. http://elibrary.ru/item.asp?id=43885950
4. Chang KJ, Chen JH, Chen KH. The Pathophysiological Mechanism and Clinical Treatment of Polycystic Ovary Syndrome: A Molecular and Cellular Review of the Literature. Int J Mol Sci. 2024;25(16):9037-9037.
https://doi.org/10.3390/ijms25169037
5. ESHRE 2023: PCOS – Update of the International Guidelines [Internet]. Ciplamed.com. 2023 [cited 2025 Jun 14]. Available from:
6. Tsiami AP, Karkanaki A, Dimitriadis GK, Christodoulaki C, Calis KA, Piperi C. Higher Ovulation Rate with Letrozole as Compared with Clomiphene Citrate in Infertile Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis. Hormones (Athens). 2021;20:449-461.
https://doi.org/10.1007/s42000-021-00289-z
7. Liu Z, Zhang M, Zhang Q, Xue Q. Letrozole Compared with Clomiphene Citrate for Polycystic Ovarian Syndrome: A Systematic Review and Meta-Analysis. Obstet Gynecol. 2023;141:523–534.
https://doi.org/10.1097/AOG.0000000000005070
8. Mukherjee AG, Kalyani A, Das S, Gupta S, Chatterjee S. Letrozole: Pharmacology, Toxicity and Potential Therapeutic Effects. Life Sci. 2022;310:121074.
https://doi.org/10.1016/j.lfs.2022.121074
9. Forslund M, Jensen ML, Grinsted J, Glintborg D, Ravn P, Andersen MS. Different Kinds of Oral Contraceptive Pills in Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis. Eur J Endocrinol. 2023;189:S1–S16.
https://doi.org/10.1093/ejendo/lvad082
10. Abdalla MA, Siddiqui MF, Alnaimy AR, Islam N. A Review of Therapeutic Options for Managing the Metabolic Aspects of Polycystic Ovary Syndrome. Ther Adv Endocrinol Metab. 2020;11:2042018820938305.
https://doi.org/10.1177/2042018820938305
11. Zhao H, Lin S, Li Y, Li X, Wang W, Zhang W. Comparative Efficacy of Oral Insulin Sensitizers Metformin, Thiazolidinediones, Inositol, and Berberine in Improving Endocrine and Metabolic Profiles in Women with PCOS: A Network Meta-Analysis. Reprod Health. 2021;18:171.
https://doi.org/10.1186/s12978-021-01207-7
12. Lv Z, Guo Y. Metformin and Its Benefits for Various Diseases. Front Endocrinol. 2020;11:191.
https://doi.org/10.3389/fendo.2020.00191
13. Deswal R, Narwal V, Dang A, Pundir CS. The Prevalence of Polycystic Ovary Syndrome: A Brief Systematic Review. J Hum Reprod Sci. 2020;13(4):261–271.
https://doi.org/10.4103/jhrs.JHRS_95_18
14. Dumesic DA, Oberfield SE, Stener-Victorin E, Marshall JC, Laven JS, Legro RS. Scientific Statement on the Diagnostic Criteria, Epidemiology, Pathophysiology, and Molecular Genetics of Polycystic Ovary Syndrome. Endocrine Rev. 2022;36(5):487–525.
https://doi.org/10.1210/er.2015-1018
15. Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran L, Piltonen T, Norman RJ; International PCOS Network. Recommendations from the International Evidence-Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Hum Reprod. 2020;33(9):1602–1618.
https://doi.org/10.1093/humrep/dey256
16. Escobar-Morreale HF. Polycystic Ovary Syndrome: Definition, Aetiology, Diagnosis and Treatment. Nat Rev Endocrinol. 2021;14(5):270–284.
https://doi.org/10.1038/nrendo.2018.24
17. Rosenfield RL, Ehrmann DA. The Pathogenesis of Polycystic Ovary Syndrome (PCOS): The Hypothesis of PCOS as Functional Ovarian Hyperandrogenism Revisited. Endocrine Rev. 2020;37(5):467–520.
https://doi.org/10.1210/er.2015-1104
18. Azziz R, Carmina E, Chen Z, Dunaif A, Laven JS, Legro RS, Lizneva D, Natterson-Horowtiz B, Teede HJ, Yildiz BO. Polycystic Ovary Syndrome. Nat Rev Dis Primers. 2020;2:16057.
https://doi.org/10.1038/nrdp.2016.57
19. Панарина О.В., Рашидова М.А., Беленькая Л.В., Трофимова Т.А., Шолохов Л.Ф. Современные представления о патогенезе синдрома поликистозных яичников (обзор литературы). Acta Biomed Sci. 2017;2 (4 (116)):9-14.
Panarina O.V., Rashidova M.A., Belenkaya L.V., Trofimova T.A., Sholokhov L.F. Modern ideas about the pathogenesis of polycystic ovary syndrome (literature review). Acta Biomed Sci. 2017;2 (4 (116)):9-14. Russian.
20. Della Corte L, Barra F, Farthing A, Bifulco G, Di Martino G, Ferrero S, Giampaolino P. Is There Still a Place for Surgery in Patients with PCOS? A Review. Life. 2023;13:1270.
https://doi.org/10.3390/life13061270
21. Солопова А.Г., Макацария А.Д., Солопова А.Е., Никифорова О.В. Склерокистозные яичники: современный взгляд на проблему. Акушерство, гинекология и репродукция. 2017; 11 (2): 57-68.
Solopova AG, Makatsariya AD, Solopova AE, Nikiforova OV. Sclerocystic ovaries: current approaches to the problem. Obstetrics, gynecology and reproduction. [Akusherstvo, ginekologiya i reproduktsiya]. 2017;11(2):57-68. Russian).
https://doi.org/10.17749/2313-7347.2017.11.2.057-068
22. Deswal R, Narwal V, Dang A, Pundir CS. The Prevalence of Polycystic Ovary Syndrome: A Brief Systematic Review. J Hum Reprod Sci. 2020;13:261–271.
https://doi.org/10.4103/jhrs.JHRS_95_18
23. Singh S, Pal N, Shubham S, Sarma DK, Verma V, Marotta F, Kumar M. Polycystic Ovary Syndrome: Etiology, Current Management, and Future Therapeutics. J Clin Med. 2023;12:1454.
https://doi.org/10.3390/jcm12041454
24. Базарбаева А.Е., Айнабек А.Қ., Сарыбай М.Ш., Амирбекова Ж.Т. Синдром поликистозных яичников: современные методы лечения (обзор литературы). Репродуктивная медицина (Центральная Азия). 2025;1:444.
Bazarbaeva AE, Aynaбек AK, Sarybai MSh, Amirbekova ZhT. Polycystic Ovary Syndrome: Modern Treatment Methods (Literature Review). Reproductive Medicine (Central Asia). 2025;1:444. Russian.
https://doi.org/10.37800/RM.1.2025.444
25. Коркан А.И., Туреханова А.Д., Тюгай Ю.Л. Современные методы лечения синдрома поликистозных яичников (обзор литературы). Репродуктивная медицина. 2020;1(42):27-34.
Korkan AI, Turekhanova AD, Tyugai YuL. Modern Treatment Methods for Polycystic Ovary Syndrome (Literature Review). Reproductive Medicine. 2020;1(42):27-34. Russian.
https://doi.org/10.37800/rm2020-1-5
26. Мамедалиева Н.М., Грушевский В.Е., Суюмбаева Г.М., Апселенова М.К. Современные аспекты синдрома поликистозных яичников. Вестник КазНМУ. 2015;(2):23-27.
Mamedaliyeva NM, Grushevsky VE, Suyumbaeva GM, Apselenova MK. Modern aspects of polycystic ovary syndrome. Vestnik KazNMU. 2015;(2):23-27. Russian.
https://www.elibrary.ru/item.asp?id=36914564
27. Лазарева Л.М. Распространённость синдрома поликистозных яичников в популяции женщин репродуктивного возраста при использовании критериев Rotterdam 2003 (обзор литературы). Acta Biomed Sci. 2023;8(4):59-67.
Lazareva LM. Prevalence of polycystic ovary syndrome in the population of reproductive-age women based on the 2003 Rotterdam criteria (literature review). Acta Biomed Sci. 2023;8(4):59-67. Russian.
https://doi.org/10.29413/ABS.2023-8.4.7
28. Жуковская С.В. мл., Жуковская С.В. Современный практический подход к преодолению бесплодия у пациенток с синдромом поликистозных яичников. Репрод здор. Вост Евр. 2018;8(6):838-851.
Zhukovskaya SV Jr, Zhukovskaya SV. A modern practical approach to overcoming infertility in patients with polycystic ovary syndrome. Reprod Health East Eur. 2018;8(6):838-851. Russian.
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