Journal of Multidisciplinary Sciences,
Journal Year:
2023,
Volume and Issue:
5(1), P. 37 - 49
Published: June 30, 2023
In
women
of
childbearing
age,
polycystic
ovarian
syndrome
(PCOS)
is
the
most
common
endocrine
and
metabolic
condition.
Ovulatory
dysfunction,
clinical
symptoms
hyperandrogenism,
multiple
cystic
ovaries
are
hallmarks
PCOS.
Women
who
have
PCOS
may
irregular
insulin
activity
in
addition
to
other
difficulties
such
as
pattern
hair
loss,
acne,
obesity,
infertility,
hirsutism.
An
unhealthy
lifestyle,
hereditary
causes,
androgen
exposures,
neuroendocrine
factors
frequently
causes
This
results
an
unbalanced
hormonal
state,
high
insulin,
inflammation.
Due
overlapping
issues,
patients'
cancer
risk
has
been
subject
debate
for
decades.This
review
article
examines
relationship
between
various
types
reproductive
cancers,
focusing
on
possible
reasons
patients.
European Journal of Endocrinology,
Journal Year:
2023,
Volume and Issue:
189(1), P. S1 - S16
Published: July 1, 2023
To
compare
between
different
combined
oral
contraceptive
pills
(COCPs)
as
part
of
the
update
International
Evidence-Based
Guidelines
on
Assessment
and
Management
polycystic
ovary
syndrome
(PCOS).A
systematic
review
meta-analysis
was
performed,
Prospero
CRD42022345640.MEDLINE,
EMBASE,
All
EBM,
CINAHL,
PsycINFO
searched
July,
8,
2022,
for
studies
including
women
with
PCOS,
comparing
2
COCPs
in
randomized
controlled
trials.A
total
1660
were
identified,
19
trials
(RCTs)
included.Fourth-generation
COCP
resulted
lower
body
mass
index
(BMI)
(mean
difference
[MD]
1.17
kg/m2
[95%
confidence
interval
{CI}
0.33;
2.02])
testosterone
(MD
0.60
nmol/L
CI
0.13;
1.07])
compared
third-generation
agents,
but
no
seen
hirsutism.Ethinyl
estradiol
(EE)/cyproterone
acetate
(CPA)
better
reducing
hirsutism
well
biochemical
hyperandrogenism
(testosterone
[MD
0.38
{95%
0.33-0.43}])
BMI
0.62
0.05-1.20])
conventional
COCPs.There
high
low
EE
doses.
No
evidence
regarding
natural
estrogens
identified.With
current
evidence,
regimens
containing
an
antiandrogen
(EE/CPA)
may
be
hyperandrogenism,
EE/CPA
will
not
recommended
a
first-line
treatment
by
pending
PCOS
guideline
update,
due
to
higher
venous
thrombotic
events
(VTE)
risk
general
population.
Later-generation
progestins
offer
theoretical
benefits,
clinical
outcomes
is
needed
PCOS.The
protocol
registered
prospectively
Prospero,
CRD42022345640.
The Journal of Clinical Endocrinology & Metabolism,
Journal Year:
2023,
Volume and Issue:
109(2), P. e817 - e836
Published: Aug. 9, 2023
Abstract
Context
Polycystic
ovary
syndrome
(PCOS)
affects
more
than
1
in
10
women.
Objective
As
part
of
the
2023
International
PCOS
Guidelines
update,
comparisons
between
combined
oral
contraceptive
pills
(COCP),
metformin,
and
combination
treatment
were
evaluated.
Data
Sources
Ovid
Medline,
Embase,
PsycINFO,
All
EBM,
CINAHL
searched.
Study
Selection
Women
with
included
randomized
controlled
trials
(RCTs).
Extraction
We
calculated
mean
differences
95%
CIs
regarding
anthropometrics,
metabolic,
hyperandrogenic
outcomes.
Meta-analyses
quality
assessment
using
GRADE
performed.
Synthesis
The
search
identified
1660
publications;
36
RCTs
included.
For
hirsutism,
no
seen
when
comparing
metformin
vs
COCP,
nor
COCP
COCP.
Metformin
was
inferior
on
free
androgen
index
(FAI)
(7.08;
CI
4.81,
9.36),
sex
hormone
binding
globulin
(SHBG)
(−118.61
nmol/L;
−174.46,
−62.75)
testosterone
(0.48
0.32,
0.64)
compared
for
FAI
(0.58;
0.36,
0.80)
SHBG
(−16.61
−28.51,
−4.71)
treatment,
whereas
did
not
differ.
lowered
insulin
(−27.12
pmol/L;
−40.65,
−13.59)
triglycerides
(−0.15
mmol/L;
−0.29,
−0.01)
(17.03
7.79,
26.26)
resistance
(0.44;
0.17,
0.70)
treatment.
Conclusions
choice
or
should
be
based
symptoms,
noting
some
biochemical
benefits
from
targeting
both
major
endocrine
disturbances
(hyperinsulinemia
hyperandrogenism).
EClinicalMedicine,
Journal Year:
2023,
Volume and Issue:
63, P. 102162 - 102162
Published: Aug. 9, 2023
Anti-androgens
and
combined
oral
contraceptive
pills
(COCPs)
may
mitigate
hyperandrogenism-related
symptoms
of
polycystic
ovary
syndrome
(PCOS).
However,
their
efficacy
safety
in
PCOS
remain
unclear
as
previous
reviews
have
focused
on
non-PCOS
populations.
To
inform
the
2023
International
Evidence-based
Guideline
PCOS,
we
conducted
first
systematic
review
meta-analysis
investigating
anti-androgens
management
hormonal
clinical
features
PCOS.We
systematically
searched
MEDLINE,
Embase,
PsycInfo,
All
EBM
reviews,
CINAHL
up
to
28th
June
for
randomised
controlled
trials
(RCTs)
examining
anti-androgen
use,
alone
or
combination
with
metformin,
COCPs,
lifestyle,
other
interventions,
women
any
age,
diagnosed
by
Rotterdam,
National
Institutes
Health
Androgen
Excess
&
Society
criteria,
using
a
form
contraception.
Non-English
studies
less
than
6
months
duration
which
used
same
regimen
both/all
groups
were
excluded
order
establish
outcomes
interest.
Three
authors
screened
articles
against
selection
criteria
assessed
risk
bias
quality
Grading
Recommendations,
Assessment,
Development
Evaluations
(GRADE)
framework.
Critical
(prioritised
during
guideline
development
GRADE
purposes)
included
weight,
body
mass
index
(BMI),
irregular
cycles,
hirsutism,
liver
function,
life.
Random
effects
meta-analyses
where
appropriate.
This
study
is
registered
PROSPERO,
CRD42022345640.From
1660
identified
search,
27
comprising
20
unique
included.
Of
these,
13
(n
=
961)
pooled
meta-analysis.
Seven
had
high
bias,
nine
moderate
four
low.
finasteride,
flutamide,
spironolactone,
bicalutamide.
In
meta-analysis,
+
lifestyle
superior
metformin
hirsutism
(weighted
mean
difference
[WMD]
[95%
CI]:
-1.59
[-3.06,
-0.12],
p
0.03;
I2
74%),
SHBG
(7.70
nmol/l
[0.75,
14.66],
0%),
fasting
insulin
insulin:
glucose
ratio
(-2.11
μU/ml
[-3.97,
-0.26],
0%
-1.12
[-1.44,
-0.79],
<
0.0001,
0%,
respectively),
but
not
placebo
(-0.93,
[-3.37,
1.51],
0.45;
76%)
(9.72
[-0.71,
20.14],
0.07;
31%).
Daily
use
was
more
effective
every
three
days
(-3.48
[-4.58,
-2.39],
1%),
resulted
lower
androstenedione
levels
(-0.30
ng/ml
[-0.50,
-0.10],
0.004;
0%).
Combination
treatment
testosterone
compared
(-0.29
[-0.52,
-0.06],
0.01;
61%),
there
no
differences
when
either
lifestyle.
limited
2
trials),
combining
COCP
poorer
lipid
profiles
±
placebo,
outcomes.Current
evidence
does
support
preferentially
COCPs
treat
hyperandrogenism
PCOS.
could
be
considered
are
contraindicated,
poorly
tolerated,
present
sub-optimal
response
after
minimum
6-month
period,
consideration
context
individual
factors
characteristics.National
Medical
Research
Council
(NHMRC)
Australia
Monash
University.
BMC Medicine,
Journal Year:
2025,
Volume and Issue:
23(1)
Published: March 11, 2025
During
adolescence,
accurate
diagnostic
criteria
and/or
identification
of
adolescents
"at
risk"
polycystic
ovary
syndrome
(PCOS)
are
critical
to
establish
appropriate
screening,
treatment,
and
lifelong
health
plans.
The
2023
International
Evidence-Based
Guideline
for
PCOS
aimed
provide
the
most
up-to-date
evidence-based
recommendations
improve
outcomes
individuals
with
PCOS,
emphasizing
timely
diagnosis
from
adolescence.
best
practice
methods
following
Appraisal
Guidelines
Research
Evaluation
(AGREE-II)
were
applied.
Healthcare
professionals
patients/consumers
reviewed
extensive
evidence
synthesis/meta-analysis
55
prioritized
clinical
questions.
Databases
(OVID
MEDLINE,
All
EBM,
PsycInfo,
EMBASE,
CINAHL)
searched
until
August
2022
as
part
update
Guideline.
Grading
Recommendations,
Assessment,
Development,
(GRADE)
framework
guided
experts
on
quality,
feasibility,
acceptability,
cost,
implementation,
ultimately
recommendation
strength.
This
manuscript
focuses
adolescent-specific
is
based
presence
both
irregular
menstrual
cycles
(defined
according
time
postmenarche)
clinical/biochemical
hyperandrogenism
exclusion
other
disorders
that
mimic
PCOS.
Adolescents
only
one
these
features
can
be
considered
requiring
management
symptoms
ongoing
follow-up.
Polycystic
ovarian
morphology
pelvic
ultrasonography
or
anti-Müllerian
hormone
levels
should
not
used
during
Lifelong
planning
recommended
include
healthy
lifestyles,
screening
depression
metabolic
transition
adult
care,
all
underpinned
by
shared
decision-making.
explain
weight-related
risks
adolescents,
while
minimizing
weight
stigma.
In
combined
oral
contraceptive
pills
indicated
irregularity
hyperandrogenism,
focusing
low
dose
preparations,
metformin
could
cycle
regulation.
Overall,
limited
in
moderate
certainty
evidence.
Extensive
international
engagement
rigorous
processes
generated
differ
clarified
strategies
Clinical Endocrinology,
Journal Year:
2023,
Volume and Issue:
99(1), P. 79 - 91
Published: March 20, 2023
Abstract
Objective
As
part
of
the
update
International
Evidence‐Based
Guidelines
for
Assessment
and
Management
polycystic
ovary
syndrome
(PCOS),
a
systematic
review
was
performed
to
inform
evidence‐based
recommendations.
Design
Systematic
review.
Only
randomised
controlled
trial
were
included.
Patients
Women
with
PCOS;
use
combined
oral
contraceptive
pills
(COCP)
compared
no
medical
treatment.
Measurements
Outcomes
designed
in
collaboration
clinical
experts,
researchers,
consumers.
Critical
outcomes
included
hirsutism,
irregular
cycles,
quality
life,
body
mass
index
(BMI),
weight.
Results
1660
publications
identified,
but
only
four
studies
No
could
be
meta‐analysis.
COCP
treatment
improved
cycle
regularity
(100%
vs.
0%,
low
certainty
evidence).
showed
difference
improvement
hirsutism
or
BMI
placebo
lifestyle;
lower
weight
after
(mean
[MD]
−8.0
(95%
confidence
interval,
CI
−11.67);
−4.33
kg);
life
(MD
1.2
[95%
0.96];
1.44),
these
results
all
very
evidence.
Conclusion
show
that
benefit
regulation,
other
benefits
potential
adverse
effects
identified
The
is
frontline
PCOS,
this
still
based
on
established
efficacy
broader
general
population.
Our
research
PCOS
seriously
lacking
should
prioritised
capture
core
reproductive,
metabolic
psychological
important
PCOS.
Acta Obstetricia Et Gynecologica Scandinavica,
Journal Year:
2023,
Volume and Issue:
103(1), P. 7 - 12
Published: Nov. 20, 2023
Abstract
Polycystic
ovary
syndrome
(PCOS)
affects
about
12%
of
women
reproductive
age.
In
2018,
the
first
evidence‐based
guideline
on
assessment
and
management
PCOS
was
published,
an
updated
extended
released
in
August
2023.
These
guidelines
followed
best
practice
are
endorsed
by
39
organizations
worldwide,
making
them
most
robust
source
evidence
to
guide
clinical
practice.
2023
guideline,
diagnostic
criteria
have
been
further
refined
as
polycystic
morphology
can
now
be
assessed
with
gynecological
ultrasound
or
elevated
anti‐Müllerian
hormone
levels.
A
healthy
lifestyle
should
at
focus
care
for
all
PCOS;
however,
no
specific
diet
physical
exercise
recommended.
The
latest
medical
treatments
fertility
reviewed,
including
special
considerations
regarding
long‐term
follow‐up
metabolic
psychiatric
comorbidities
pregnancy
PCOS.
Here
we
summarize
recommendations
from
a
Nordic
perspective.
Physiological Reports,
Journal Year:
2025,
Volume and Issue:
13(7)
Published: April 1, 2025
Polycystic
ovary
syndrome
(PCOS)
causes
the
impairment
of
female
fertility
and
elevates
risk
metabolic
disorders.
The
current
study
aimed
to
evaluate
effects
rosmarinic
acid
(Ros)
on
ovarian
histo-stereology,
level
reproductive
hormones,
inflammation
in
a
rat
model
PCOS.
Fifteen
adult
Sprague
Dawley
rats
were
randomly
divided
into
three
groups,
including
controls,
PCOS,
PCOS+Ros
(receiving
25
mg/kg
Ros
for
39
days).
After
treatments,
inflammatory
markers
analyzed.
PCOS
led
increased
weight
volume,
cortical
medullary
expansion,
reduced
follicles,
enhanced
follicular
atresia.
It
also
caused
hormonal
imbalances,
elevating
LH,
FSH,
testosterone
while
decreasing
estradiol,
progesterone,
AMH.
Additionally,
pro-inflammatory
(TNF-α
IL-6)
decreased
anti-inflammatory
(IL-4
IL-10).
However,
administration
animals
improved
structure,
follicle
numbers,
atresia,
balanced
restored
(p
value
<0.05).
present
findings
may
suggest
as
novel
strategy
management
although
further
studies
are
necessary.
