From Pathophysiology to Treatment: Navigating the Challenges of Polycystic Ovary Syndrome

Polycystic Ovary Syndrome (PCOS) is a common but complex endocrine disorder that affects a significant number of women of reproductive age. It is characterized by a range of symptoms, including irregular menstrual cycles, hyperandrogenism (excessive male hormones leading to symptoms such as hirsutism and acne), and the presence of multiple cysts in the ovaries. However, PCOS is not limited to reproductive health; it has profound metabolic implications, increasing the risk of obesity, insulin resistance, Type 2 Diabetes Mellitus, and cardiovascular diseases. The pathophysiology of PCOS remains incompletely understood, but it is thought to involve hormonal imbalances, including elevated levels of luteinizing hormone (LH) and insulin resistance, which contribute to ovarian dysfunction and anovulation. The disorder’s molecular mechanisms are still being studied, with genetic and environmental factors likely playing roles in its development. One of the challenges in diagnosing PCOS is its heterogeneity, as the severity and presence of symptoms can vary greatly between individuals. This has led to multiple diagnostic criteria, with the Rotterdam Criteria being the most widely accepted, requiring at least two of the following three features: irregular ovulation, hyperandrogenism, and polycystic ovaries. Treatment for PCOS typically includes both pharmacological and non-pharmacological strategies. Pharmacologically, oral contraceptives are commonly used to regulate menstrual cycles and reduce hyperandrogenism, while medications like metformin can help address insulin resistance. Non-pharmacological approaches, such as weight management and lifestyle modifications, are also important in improving metabolic health. New avenues for research are focusing on the molecular pathways involved in PCOS, with an emphasis on developing personalized therapies that target the underlying causes of the disorder rather than just alleviating symptoms.