This systematic review documents the effectiveness of combined oral contraceptive pills in treating hyperandrogenism and irregular menses, and of metformin in addressing the metabolic disturbances in women with polycystic ovary syndrome.
Rare noncoding variants of the gene DENND1A, previously shown to play a key role in androgen biosynthesis in human ovarian theca cells, are significantly associated with familial polycystic ovary syndrome.
Emerging evidence supports that two metabolic phenotypes exist among women with PCOS. For metabolically healthy PCOS patients, managing menstrual symptoms, anovulation and androgen excess with COCs provides a simple and well-tolerated treatment regimen. In contrast, PCOS patients with metabolic syndrome are at high risk for type 2 diabetes, and COC use may contribute to hyperinsulinemia, adverse lipid changes, and endothelial changes associated with adverse cardiovascular risk. The use of a levonorgestrel intrauterine device combined with spironolactone (to manage hyperandrogenism) and metformin (to manage hyperinsulinism) may offer advantages to metabolically unhealthy PCOS patients.
Women diagnosed with polycystic ovary syndrome (PCOS) face an elevated risk of developing heart disease, diabetes, mental health conditions, reproductive disorders, and cancer of the lining of the uterus.