Polycystic Ovary Syndrome: A Review of Current Knowledge

Abstract Context Polycystic ovary syndrome (PCOS) is a common endocrine condition affecting 8% to 13% of women across the lifespan. PCOS affects reproductive, metabolic, and mental health, generating a considerable health burden. Advances in treatment of women with PCOS has been hampered by evolving diagnostic criteria and poor recognition by clinicians. This has resulted in limited clinical and basic research. In this study, we provide insights into the current and future research on the metabolic features of PCOS, specifically as they relate to PCOS-specific insulin resistance (IR), that may affect the most metabolically active tissue, skeletal muscle. Current Knowledge PCOS is a highly heritable condition, yet it is phenotypically heterogeneous in both reproductive and metabolic features. Human studies thus far have not identified molecular mechanisms of PCOS-specific IR in skeletal muscle. However, recent research has provided new insights that implicate energy-sensing pathways regulated via epigenomic and resultant transcriptomic changes. Animal models, while in existence, have been underused in exploring molecular mechanisms of IR in PCOS and specifically in skeletal muscle. Future Directions Based on the latest evidence synthesis and technologies, researchers exploring molecular mechanisms of IR in PCOS, specifically in muscle, will likely need to generate new hypothesis to be tested in human and animal studies. Conclusion Investigations to elucidate the molecular mechanisms driving IR in PCOS are in their early stages, yet remarkable advances have been made in skeletal muscle. Overall, investigations have thus far created more questions than answers, which provide new opportunities to study complex endocrine conditions.

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Correlation between Iron Status Parameters and Hormone Levels in Women with Polycystic Ovary Syndrome

Clinical Medicine Insights Women s Health ◽

10.4137/cmwh.s8780 ◽

2012 ◽

Vol 5 ◽

pp. CMWH.S8780 ◽

Cited By ~ 2

Author(s):

Hussein Kadhem Al-Hakeim

Keyword(s):

Polycystic Ovary Syndrome ◽

Current Knowledge ◽

Polycystic Ovary ◽

Iron Status ◽

Endocrine System ◽

Serum Testosterone ◽

Iron Store ◽

Ovary Syndrome ◽

Iron Stores ◽

Body Iron Store

Much research has shown that iron store parameters are increased in women with polycystic ovary syndrome (PCOS), but an exact explanation for this phenomenon remains unavailable. The objective of this study was to investigate the correlation between iron status parameters and hormonal disturbances in women with PCOS that accounts for their increased iron store levels. Iron status parameters and hormones were measured using colorimetric and enzyme-linked immunosorbent assays, respectively. The results demonstrated a mild iron overload in the patients with PCOS. Good positive correlations between iron status parameters and serum testosterone, prolactin, and insulin were detected in the patient group, whereas iron status parameters and BMI were not significantly correlated. The data also suggest that the increase in serum ferritin and body iron store levels in patients with PCOS are associated with hyperandrogenemia, hyperprolactinemia, and hyperinsulinemia. The findings of this study expand current knowledge on the factors affecting iron stores and suggest a different mechanism of interaction between iron stores and the endocrine system through the harmful deposition of iron in endocrine glands and through hormonal effects on iron absorption and metabolism.

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Selenium and Polycystic Ovary Syndrome; Current Knowledge and Future Directions: A Systematic Review

Hormone and Metabolic Research ◽

10.1055/a-0890-6823 ◽

2019 ◽

Vol 51 (05) ◽

pp. 279-287 ◽

Cited By ~ 3

Author(s):

Fatemeh Hajizadeh-Sharafabad ◽

Jalal Moludi ◽

Helda Tutunchi ◽

Ehsaneh Taheri ◽

Azimeh Izadi ◽

...

Keyword(s):

Systematic Review ◽

Insulin Resistance ◽

Polycystic Ovary Syndrome ◽

Current Knowledge ◽

Polycystic Ovary ◽

Therapeutic Effects ◽

Protective Effects ◽

Case Control Studies ◽

Ovary Syndrome ◽

The Impact

AbstractPolycystic ovary syndrome (PCOS), as the most common endocrine disorder in reproductive-aged women, is recognized by hyperandrogenism and insulin resistance. Selenium (Se) potentially possesses therapeutic effects on PCOS due to antioxidant and insulin-like properties. This systematic review evaluates the potential role of Se in the complications of PCOS. A systematic review was performed on published studies reporting the effects of Se on PCOS. Three major databases including PubMed, Scopus, and Google Scholar were searched until December 2018. A total of 7 human studies and two in vitro studies met the inclusion criteria. Two out of three case-control studies showed that serum Se levels tend to decrease in patients with PCOS. Of four studies that evaluated the impact of Se supplementation on insulin resistance, only one study showed protective effects of Se against insulin resistance. Two out of three studies reported the antioxidant effect of Se. Few studies investigating anti-androgenic effect of Se presented controversial results. There were three studies that evaluated the anti-hyperlipidemic effect of Se, of which two surveys indicated the lowering effects of Se on VLDL and LDL-cholesterol. The reviewed studies confirmed inverse relationships between serum Se levels and some androgenic hormones in PCOS. Se is able to attenuate insulin resistance and dyslipidemia. The available data are currently insufficient to support the protective effects of Se on PCOS.

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PCOS and Hyperprolactinemia: what do we know in 2019?

Clinical Medicine Insights Reproductive Health ◽

10.1177/1179558119871921 ◽

2019 ◽

Vol 13 ◽

pp. 117955811987192 ◽

Cited By ~ 2

Author(s):

Clémence Delcour ◽

Geoffroy Robin ◽

Jacques Young ◽

Didier Dewailly

Keyword(s):

Polycystic Ovary Syndrome ◽

Current Knowledge ◽

Polycystic Ovary ◽

Pcos Patient ◽

Patient Needs ◽

Ovary Syndrome ◽

Imaging Methods ◽

Endocrine Diseases ◽

Diagnosis Criteria ◽

Permanent Increase

Polycystic ovary syndrome (PCOS) and hyperprolactinemia (HPRL) are the two most common etiologies of anovulation in women. Since the 1950s, some authors think that there is a pathophysiological link between PCOS and HPRL. Since then, many authors have speculated about the link between these two endocrine entities, but no hypothesis proposed so far could ever be confirmed. Furthermore, PCOS and HPRL are frequent endocrine diseases and a fortuitous association cannot be excluded. The evolution of knowledge about PCOS and HPRL shows that studies conducted before the 2000s are obsolete given current knowledge. Indeed, most of the studies were conducted before consensual diagnosis criteria of PCOS and included small numbers of patients. In addition, the investigation of HPRL in these studies relied on obsolete methods and did not look for the presence of macroprolactinemia. It is therefore possible that HPRL that has been attributed to PCOS corresponded in fact to macroprolactinemia or to pituitary microadenomas of small sizes that could not be detected with the imaging methods of the time. Recent studies that have conducted a rigorous etiological investigation show that HPRL found in PCOS correspond either to non-permanent increase of prolactin levels, to macroprolactinemia or to other etiologies. None of this recent study found HPRL related to PCOS in these patients. Thus, the link between PCOS and HPRL seems to be more of a myth than a well-established medical reality and we believe that the discovery of an HPRL in a PCOS patient needs a standard etiological investigation of HPRL.

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Ovarian and extra-ovarian mediators in the development of polycystic ovary syndrome

Journal of Molecular Endocrinology ◽

10.1530/jme-18-0079 ◽

2018 ◽

Vol 61 (4) ◽

pp. R161-R184 ◽

Cited By ~ 9

Author(s):

Muraly Puttabyatappa ◽

Vasantha Padmanabhan

Keyword(s):

Polycystic Ovary Syndrome ◽

Current Knowledge ◽

Polycystic Ovary ◽

Reproductive Age ◽

Women Of Reproductive Age ◽

Ovary Syndrome ◽

Endocrine Disorder ◽

Treatment And Prevention ◽

Gene Environment

Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine disorder affecting women of reproductive age. The origin of PCOS is still not clear and appears to be a function of gene × environment interactions. This review addresses the current knowledge of the genetic and developmental contributions to the etiology of PCOS, the ovarian and extra-ovarian mediators of PCOS and the gaps and key challenges that need to be addressed in the diagnosis, treatment and prevention of PCOS.

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Natural Molecules in the Management of Polycystic Ovary Syndrome (PCOS): An Analytical Review

Nutrients ◽

10.3390/nu13051677 ◽

2021 ◽

Vol 13 (5) ◽

pp. 1677

Author(s):

Matteo Iervolino ◽

Elisa Lepore ◽

Gianpiero Forte ◽

Antonio Simone Laganà ◽

Giovanni Buzzaccarini ◽

...

Keyword(s):

Polycystic Ovary Syndrome ◽

Current Knowledge ◽

Polycystic Ovary ◽

Elevated Serum ◽

Serum Levels ◽

Reproductive Age ◽

Omega 3 ◽

Ovary Syndrome ◽

Comprehensive Overview ◽

Analytical Review

Polycystic ovary syndrome (PCOS) is a heterogenous disorder characterized by chronic ovulation dysfunction and hyperandrogenism. It is considered the most common endocrinological disorder, affecting up to 25% of women of reproductive age, and associated with long-term metabolic abnormalities predisposing to cardiovascular risk, such as insulin resistance (IR), dyslipidemia, endothelial dysfunction, and systemic inflammation. PCOS is also characterized by elevated serum levels of luteinizing hormone (LH), causing a condition of hyperandrogenism and a consequent altered ratio between LH and the follicle stimulating hormone (FSH). Over the years, several different approaches have been proposed to alleviate PCOS symptoms. Supplementation with natural molecules such as inositols, resveratrol, flavonoids and flavones, vitamin C, vitamin E and vitamin D, and omega-3 fatty acids may contribute to overcoming PCOS pathological features, including the presence of immature oocyte, IR, hyperandrogenism, oxidative stress and inflammation. This review provides a comprehensive overview of the current knowledge about the efficacy of natural molecule supplementation in the management of PCOS.

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