Novel strategies in the management of polycystic ovary syndrome
Author
dc.contributor.author
Spritzer, P. M.
Author
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Motta, A. B.
Author
dc.contributor.author
Sir Petermann, Teresa
Author
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Diamanti Kandarakis, E.
Admission date
dc.date.accessioned
2015-12-23T02:48:11Z
Available date
dc.date.available
2015-12-23T02:48:11Z
Publication date
dc.date.issued
2015
Cita de ítem
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Minerva Endocrinologica 2015;Vol. 40 - No. 1
en_US
Identifier
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https://repositorio.uchile.cl/handle/2250/135944
General note
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Artículo de publicación ISI
en_US
Abstract
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Polycystic ovary syndrome (PCOS) is a common endocrinopathy affecting reproductive-aged women. PCOS has been recognized as a syndrome combining reproductive and metabolic abnormalities with lifelong health implications. Cardiometabolic alterations require regular screening and effective and targeted lifestyle advice to lose weight as well as to prevent weight gain. Pharmacological therapy includes insulin-sensitizer drugs and agents that act directly on metabolic comorbidities, such as statins and antiobesity drugs. Bariatric surgery may be an option for severely obese women with PCOS Regarding reproductive aspects, ovulation induction with antiestrogens such as clomipherte citrate or letrozole is the first-line medical treatment. Exogenous gonadotropins and in vitro fertilization (IVF) are recommended as second-line treatment for anovulatory infertility. Laparoscopic ovarian diathermy may be used in special cases and metformin is no longer recommended for ovulation induction. Combined oral contraceptives (0Cs) are the first-line treatment for the management of menstrual irregularities in women not seeking pregnancy, also providing endometrial protection and contraception. Progestinonly pills or cyclical progestins are recommended for those with contraindications to OCs. Metformin is also considered a secondline choice for improving menstrual cycles in women presenting insulin-resistance and dysglicemia. Hirsutism requires cosmetic procedures and medical treatment with OCs. More severe cases may need anti-androgen drugs added to the OCs. In conclusion, strategies regarding the management of reproductive issues in PCOS encompass a tailored approach to individual needs of each patient