Therapeutic strategies for reproductive-age women with polycystic ovary syndrome: A review

Polycystic ovary syndrome (PCOS) is a significant medical and social problem, occurring in 6–20% of women in the general population and accounting for 20–25% of cases of endocrine infertility in clinical practice. The high prevalence of this condition and its role in the pathogenesis of fertility disorders underscore the importance for practicing physicians to have up-to-date knowledge on this issue. There is a need to establish theoretical foundations for the diagnosis and therapeutic approaches used by obstetricians-gynecologists and endocrinologists working with reproductive-age women with PCOS. The authors conducted a systematic analysis of data on the key mechanisms in the pathogenesis of polycystic ovary syndrome and the risk factors for its development. The clinical manifestations of this condition are described in detail, highlighting the crucial role of the physician in the early diagnosis of the disease when interacting with patients who have hormonal and metabolic disorders. The modern diagnostic criteria for PCOS are indicated, as well as the main laboratory indicators used to assess hyperandrogenism and carbohydrate metabolism disorders. The diversity of clinical symptoms and features that should be taken into account in the differential diagnosis with other diseases is noted. The mechanism of progression of insulin resistance against the background of the interrelationship between hyperinsulinemia, hyperandrogenism, and ovulation disorders is described. Options for approaches to the therapeutic management of patients with polycystic ovary syndrome are presented depending on reproductive plans, concomitant somatic diseases, and the risk of adverse side effects on the action of the drugs used. Attention is drawn to the pathogenetic justification and importance of using the hypoglycemic agent metformin, both in monotherapy and as part of a drug combination with other medications. The use of this therapeutic approach is one of the main directions in the treatment of metabolic and endocrine disorders in polycystic ovary syndrome, as it leads to the normalization of hormonal balance and ovulation by reducing hyperandrogenism and hyperinsulinemia. Pharmacological and clinical advantages of using an oral hypoglycemic drug with slow-release metformin compared to other agents have been noted. Modern pharmacological capabilities allow not only effectively eliminating disease symptoms and preventing the development of complications, but also improving reproductive health.

Hali tarjima qilinmagan