New aspects in the diagnosis and treatment of polycystic ovary syndrome

Abstract

Polycystic ovary syndrome (PCOS) is a polygenic endocrine disorder caused by both genetic and epigenetic factors. The relevance is associated with a high degree of prevalence and social significance this disease. The сombination of menstrual dysfunction, anovulatory infertility, metabolic disorders, biochemical and clinical hyperandrogenism cause the importance of this problem. In this regard, Adequate therapy and its timely intensification are the most important aspects. This article highlights basic information about diagnosis and treatment of polycystic ovary syndrome, analyzes in detail the changes in patient management tactic according to the clinical recommendations of ESHRE 2018 and 2023 the issues of the quality of life of women with PCOS. In this review, special attention will be paid to the role of metformin. According to new clinical guidelines, it can be used not only for patients with an increased body mass index (BMI), but also with a normal BMI in order to reduce insulin resistance. A new place of inositol in PCOS therapy is also considered, as an alternative way which increases the sensitivity of receptors to insulin. The treatment with aromatase inhibitors are given to solve such a problem as infertility. The article also highlights the development of treatment methods based on advances in genetics and epigenetics.