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The treatment of polycystic ovary syndrome.
Minerva Ginecol. 2004 Feb; 56(1):15-26.MG

Abstract

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women in reproductive age. As for the treatment of this disease the lack of a clear etiology for PCOS has led to a symptom-orientated treatment. However, the overall aims of treatment are to induce ovulation for women desiring conception, to reduce androgen levels, to reduce body weight and to reduce long-term health risks of diabetes mellitus and cardiovascular disease. Clomiphene citrate (CC) is recommended as first line treatment for induction of ovulation in patients with PCOS by virtue of its efficacy, safety, and ease of administration. Alternatives for CC-resistant patients include gonadotrophin therapy (better with low-dose step-up protocol) and laparoscopic ovarian diathermy. Recently, recombinant FSH (rFSH) has been introduced in clinical practice and it seems more effective than urinary FSH as demonstrated by a significantly higher number of follicles recruited and embryos obtained with a shorter treatment period. The addition of GnRH-agonist to the stimulation protocol for women affected by PCOS could reduce premature luteinization and increase cycle fecundity. Other drugs under investigation are metformin and cabergoline. Hirsutism is the manifestation of hyperandrogenemia in PCOS. The primary goal of the treatment of hirsutim is central or peripheral androgen suppression using 3 groups of drugs: inhibitors of androgen production (oral contraceptives, GnRH analogues), peripheral androgen blockers (cyproterone acetate, flutamide, finasteride and spironolactone), and insulin-sensitizing agents (metformin). Weight reduction and exercise could also improve not only menstrual disturbances and infertility, but also insulin resistance and its adverse metabolic con-sequences.

Authors+Show Affiliations

Section of Gynecology and Obstetrics and of Human Reproduction Fisiology, Department of Maternal-Infantile Surgery and Imaging Sciences, University of Cagliari, Cagliari, Italy. gineca.sajossa@tiscali.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

14973407

Citation

Ajossa, S, et al. "The Treatment of Polycystic Ovary Syndrome." Minerva Ginecologica, vol. 56, no. 1, 2004, pp. 15-26.
Ajossa S, Guerriero S, Paoletti AM, et al. The treatment of polycystic ovary syndrome. Minerva Ginecol. 2004;56(1):15-26.
Ajossa, S., Guerriero, S., Paoletti, A. M., Orrù, M., & Melis, G. B. (2004). The treatment of polycystic ovary syndrome. Minerva Ginecologica, 56(1), 15-26.
Ajossa S, et al. The Treatment of Polycystic Ovary Syndrome. Minerva Ginecol. 2004;56(1):15-26. PubMed PMID: 14973407.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The treatment of polycystic ovary syndrome. AU - Ajossa,S, AU - Guerriero,S, AU - Paoletti,A M, AU - Orrù,M, AU - Melis,G B, PY - 2004/2/20/pubmed PY - 2004/5/1/medline PY - 2004/2/20/entrez SP - 15 EP - 26 JF - Minerva ginecologica JO - Minerva Ginecol VL - 56 IS - 1 N2 - Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women in reproductive age. As for the treatment of this disease the lack of a clear etiology for PCOS has led to a symptom-orientated treatment. However, the overall aims of treatment are to induce ovulation for women desiring conception, to reduce androgen levels, to reduce body weight and to reduce long-term health risks of diabetes mellitus and cardiovascular disease. Clomiphene citrate (CC) is recommended as first line treatment for induction of ovulation in patients with PCOS by virtue of its efficacy, safety, and ease of administration. Alternatives for CC-resistant patients include gonadotrophin therapy (better with low-dose step-up protocol) and laparoscopic ovarian diathermy. Recently, recombinant FSH (rFSH) has been introduced in clinical practice and it seems more effective than urinary FSH as demonstrated by a significantly higher number of follicles recruited and embryos obtained with a shorter treatment period. The addition of GnRH-agonist to the stimulation protocol for women affected by PCOS could reduce premature luteinization and increase cycle fecundity. Other drugs under investigation are metformin and cabergoline. Hirsutism is the manifestation of hyperandrogenemia in PCOS. The primary goal of the treatment of hirsutim is central or peripheral androgen suppression using 3 groups of drugs: inhibitors of androgen production (oral contraceptives, GnRH analogues), peripheral androgen blockers (cyproterone acetate, flutamide, finasteride and spironolactone), and insulin-sensitizing agents (metformin). Weight reduction and exercise could also improve not only menstrual disturbances and infertility, but also insulin resistance and its adverse metabolic con-sequences. SN - 0026-4784 UR - https://www.unboundmedicine.com/medline/citation/14973407/The_treatment_of_polycystic_ovary_syndrome_ L2 - https://medlineplus.gov/polycysticovarysyndrome.html DB - PRIME DP - Unbound Medicine ER -