scholarly journals Polycystic Ovary Syndrome: A Comprehensive Review of Pathogenesis, Management, and Drug Repurposing

2022 ◽  
Vol 23 (2) ◽  
pp. 583
Author(s):  
Hosna Mohammad Sadeghi ◽  
Ida Adeli ◽  
Daniela Calina ◽  
Anca Oana Docea ◽  
Taraneh Mousavi ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Drug Repurposing ◽  
Environmental Toxicants ◽  
Lifestyle Modifications ◽  
Childbearing Age ◽  
Ovary Syndrome ◽  
Dipeptidyl Peptidase 4 ◽  
Dipeptidyl Peptidase 4 Inhibitors

Polycystic ovary syndrome (PCOS) is an endocrine-gynecology disorder affecting many women of childbearing age. Although a part of the involved mechanism in PCOS occurrence is discovered, the exact etiology and pathophysiology are not comprehensively understood yet. We searched PubMed for PCOS pathogenesis and management in this article and ClinicalTrials.gov for information on repurposed medications. All responsible factors behind PCOS were thoroughly evaluated. Furthermore, the complete information on PCOS commonly prescribed and repurposed medications is summarized through tables. Epigenetics, environmental toxicants, stress, diet as external factors, insulin resistance, hyperandrogenism, inflammation, oxidative stress, and obesity as internal factors were investigated. Lifestyle modifications and complementary and alternative medicines are preferred first-line therapy in many cases. Medications, including 3-hydroxy-3-methyl-3-glutaryl-coenzyme A (HMG-CoA) reductase inhibitors, thiazolidinediones, sodium-glucose cotransporter-2 inhibitors, dipeptidyl peptidase-4 inhibitors, glucose-like peptide-1 receptor agonists, mucolytic agents, and some supplements have supporting data for being repurposed in PCOS. Since there are few completed clinical trials with a low population and mostly without results on PCOS repurposed medications, it would be helpful to do further research and run well-designed clinical trials on this subject. Moreover, understanding more about PCOS would be beneficial to find new medications implying the effect via the novel discovered routes.

scholarly journals The role of vitamin D in metabolic disturbances in polycystic ovary syndrome: a systematic review

2013 ◽  
Vol 169 (6) ◽  
pp. 853-865 ◽  
Author(s):  
Y H M Krul-Poel ◽  
C Snackey ◽  
Y Louwers ◽  
P Lips ◽  
C B Lambalk ◽  
...  
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Clinical Trials ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Vitamin D Status ◽  
Regression Analyses ◽  
Metabolic Disturbances ◽  
Ovary Syndrome ◽  
Weighted Means

ContextMetabolic disturbances, in particular, insulin resistance (IR) and dyslipidemia, are common in women suffering from polycystic ovary syndrome (PCOS). Evidence is accumulating that vitamin D status may contribute to the development of metabolic disturbances in PCOS.ObjectiveThe aim of this study was to carry out a systematic review addressing the association between vitamin D status, vitamin D receptor polymorphisms, and/or polymorphisms related to vitamin D metabolism and metabolic disturbances in women with PCOS.Design and methodsA systematic search of electronic databases was carried out up to January 2013 for observational studies and clinical trials in women suffering from PCOS with outcome measures that were related to vitamin D status. We conducted univariate and multivariate regression analyses of the weighted means to gain insights into the association between vitamin D, BMI, and IR based on existing literature.ResultsWe found 29 eligible trials with inconsistency in their results. One well-designed randomized controlled trial has been carried out until now. Univariate regression analyses of the weighted means revealed vitamin D to be a significant and independent predictor of IR in both PCOS and control women. The significance disappeared after adjustment for BMI in PCOS women.ConclusionsCurrent evidence suggests an inverse association between vitamin D status and metabolic disturbances in PCOS. Owing to the heterogeneity of the studies, it is hard to draw a definite conclusion. The causal relationship between vitamin D status and metabolic disturbances in PCOS remains to be determined in well-designed placebo-controlled randomized clinical trials.

Oral probiotics in women's health: experimental evidence and results from clinical trials

2021 ◽  
Vol 20 (2) ◽  
pp. 102-109
Author(s):  
E.V. Shikh ◽  
◽  
A.A. Makhova ◽  
S.S. Sharonova ◽  
◽  
...  
Keyword(s):  
Clinical Trials ◽  
Gestational Diabetes ◽  
Polycystic Ovary Syndrome ◽  
Viral Infections ◽  
Polycystic Ovary ◽  
Gynecological Cancer ◽  
Ovary Syndrome ◽  
Treatment Regimens ◽  
Probiotic Lactobacilli

The review presents data from experimental research of the anti-inflammatory activity of Lactobacillus paracasei, L. plantarum, L. rhamnosus, the antitumor activity of L. rhamnosus GG and GR-1, L. gasseri, L. crispatus. The prospect of using probiotics in cancer treatment regimens with the aim to increase the tolerability of treatment was considered. The data confirming the ability of probiotic lactobacilli (L. reuteri and L. rhamnosus) to enhance barrier functions of endometrial epithelial cells in response to human papillomavirus-1 were presented. The perspectives of using microbiota modulation to prevent and/or protect the reproductive system against infection were discussed. The data of clinical trials using multi-strain probiotics containing Lactobacillus and Bifidobacterium in women with gestational diabetes were analyzed. A hypothesis on the role of microbiota in the pathogenesis of polycystic ovary syndrome (PCOS) was presented. Research results suggest that the use of probiotics can increase fertility in PCOS. Key words: viral infections, gestational diabetes mellitus, gynecological cancer, oral probiotics, polycystic ovary syndrome, Lactobacillus spp.

scholarly journals Towards a circulating marker of hepato‐visceral fat excess: S100A4 in adolescent girls with polycystic ovary syndrome — Evidence from randomized clinical trials

2019 ◽  
Vol 14 (5) ◽  
pp. e12500 ◽  
Author(s):  
Rita Malpique ◽  
David Sánchez‐Infantes ◽  
Cristina Garcia‐Beltran ◽  
Siri D. Taxerås ◽  
Abel López‐Bermejo ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Polycystic Ovary Syndrome ◽  
Adolescent Girls ◽  
Visceral Fat ◽  
Randomized Clinical Trials ◽  
Polycystic Ovary ◽  
Ovary Syndrome

scholarly journals A meta-analysis of the effect of sodium glucose cotransporter-2 inhibitors (SGLT-2is) on metabolic parameters in patients with polycystic ovary syndrome (PCOS)

2021 ◽  
Author(s):  
Binayak Sinha ◽  
Sami Ghosal
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Symptomatic Relief ◽  
Group Versus ◽  
Control Group ◽  
Size Estimation ◽  
Childbearing Age ◽  
Ovary Syndrome ◽  
Sodium Glucose Cotransporter

Abstract Background Polycystic ovary syndrome (PCOS) is the most common endocrinopathy among women of childbearing age and is associated with multiple morbidities. However, treatment for this condition is mainly applied for symptomatic relief and does not address the complex pathophysiology of this condition. This meta-analysis was conducted on the usage of sodium-glucose cotransporter 2 inhibitors (SGLT-2is) in PCOS because this group of drugs presents an attractive strategy to address the metabolic and hormonal defects by managing the pathophysiological defects observed in this syndrome. Methods We included prospective trials that enrolled patients with established PCOS and compared an SGLT-2i group versus a control group with at least 2 weeks of follow-up. The standardized mean difference (SMD) was used for effect size estimation from individual studies and was pooled using the fixed effect model. Results We included four trials with a pooled population of 158 patients with documented PCOS who received either an SGLT-2i or standard management. From a metabolic perspective, significant improvements were observed in the reduction in body weight (SMD: -0.68, 95% CI -1.16 to -0.19, < 0.01), fasting plasma glucose (FPG) (SMD: -0.59, 95% CI -0.99 to -0.19, P < 0.01), and insulin resistance as assessed with the HOMA-IR (SMD: -0.39, 95% CI -0.76 to -0.03, P = 0.03). In addition, a significant improvement was noted in dehydroepiandrosterone sulphate (DHEAS) levels (SMD: -0.55, 95% CI -0.94 to -0.16, P < 0.01). Conclusion SGLT-2i use is associated with salutary outcomes of metabolic and anthropometric markers of PCOS and likely favourable hormonal effects.

scholarly journals Update on polycystic ovary syndrome

2021 ◽  
Author(s):  
Jin Ju Kim
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Daily Practice ◽  
Antral Follicle ◽  
Reproductive Age ◽  
Lifestyle Modifications ◽  
First Line ◽  
Ovary Syndrome ◽  
Wide Range

Polycystic ovary syndrome (PCOS) is a common disorder in reproductive-age women. In 2018, an international evidence-based guideline announced recommendations spanning a wide range of issues on the assessment and management of PCOS. From the 166 recommendations, the present study reviews those that are of particular clinical relevance for daily practice and introduces other relevant studies that have been published since the global guideline. The 2018 guideline increased the antral follicle count cutoff for the diagnosis of PCOS from 12 to 20 when using a high-frequency probe. Hirsutism was defined as having a score of ≥4–6 based on a lower percentile of 85%–90% or cluster analysis, which was lower than the traditionally used 95th percentile-based cutoff. The diagnosis of PCOS in adolescents is challenging, and irregular menstruation was defined carefully according to years from menarche. The use of ultrasonography for the diagnosis of PCOS was restricted to those 8 years after menarche. As medication for non-fertility indications, combined oral contraceptives are the first-line drug. Metformin, in addition to lifestyle modifications, should be considered for adult patients with a body mass index ≥25 kg/m2 for the management of weight and metabolic outcomes. An aromatase inhibitor is the recommended first-line medication for ovulation induction, a subsequent individual patient data meta-analysis also reported the same conclusion. Whether the new global guideline will be fully adopted by many specialists and change clinical practice is open to question. Further studies are needed to better understand and manage PCOS patients well.

scholarly journals The conservative treatment in adolescents with the Polycystic ovary syndrome

2016 ◽  
Vol 11 (4) ◽  
pp. 337-341
Author(s):  
Adrian NEACȘU ◽  
◽  
Cătălina Diana STĂNICĂ ◽  
Constantin Dimitrie NANU ◽  
◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Lifestyle Modification ◽  
Polycystic Ovary ◽  
Obese Women ◽  
Metabolic Disturbances ◽  
Childbearing Age ◽  
Ovary Syndrome ◽  
Oral Antidiabetic Agents ◽  
Menstrual Cycles

Polycystic ovary syndrome (PCOS) is a common endocrine and heterogeneous dysfunction, characterized by chronic anovulation and androgen excess, affecting 6-10% of women of childbearing age. It is the most common cause of anovulatory infertility. It seems that the key element in the pathophysiology of PCOS is increased insulin resistance. The correction of infertility in teens is not a priority. They can receive treatment to normalize menstrual cycles, with the reduction of symptoms and improvement of metabolic disorders. Many overweight teens have increased insulinemia, which may play a role in the development of PCOS. Standard treatment is oral estroprogestative, used to perform regular menstrual cycles. Normalize menstrual cycles can be done with oral contraceptives or oral antidiabetic agents that improve metabolic dysfunctions. An adjuvant approach of the utmost importance for teens is lifestyle modification and diet. Teen treatment should be individualized depending on a number of peculiarities that have to be taken into account: menstruation disorders, mastopathies and ovarian dystrophies, hyperandrogenism syndrome, sexually transmitted diseases and other associated disorders. In obese women with PCOS, weight loss improves hyperandrogenism, reduces metabolic disturbances, reduces insulin resistance and insulinemia, improves fertility rate, stimulates ovulation.

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