Polycystic Ovary Syndrome: A Current Update from Literature
Abstract
PCOS (polycystic ovary syndrome) is an endocrine condition that affects women of reproductive age and can have catastrophic consequences. Menstrual irregularities, hirsutism, evidence of hyperandrogenism, and insulin resistance are all indicators of PCOS. PCOS individuals are more likely to suffer reproductive, metabolic, and cardiovascular problems. The pathogenesis of PCOS is complicated by a number of factors, including genetics, environmental factors, hormonal imbalances, obesity, ovarian dysfunction, and hypothalamus pituitary malformations. Despite being one of the most prevalent problems with reproductive health among women, doctors have a very difficult time offering the right kind of medical care. The major causes of this disorder's pathogenesis appear to be hyperandrogenism and insulin resistance. PCOS treatments work to reduce hyperinsulinemia, restore fertility, treat hirsutism or acne, and correct monthly irregularities. The best first-line treatment for PCOS is a lifestyle intervention that includes a healthy diet with caloric restriction, exercise to aid in weight loss and avoids future weight gain, and support for behaviour modification. Future research should concentrate on the knowledge gaps in this area. The optimum treatment for patients will be provided if those doctors are followed. The majority of PCOS patients only receive symptomatic treatment with hormones and insulin sensitizers, which results in long-term pharmaceutical dependency. There is currently no effective treatment for PCOS.
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Diamanti-Kandarakis E. PCOS in adolescents. Best Practice & Research Clinical Obstetrics & Gynaecology. 2010; 24 (2): 173–83.
Hoeger KM, Dokras A, Piltonen T. Update on PCOS: consequences, challenges, and guiding treatment. The Journal of Clinical Endocrinology & Metabolism. 2021; 106 (3): e1071–83.
Hoeger KM, Dokras A, Piltonen T. Update on PCOS: consequences, challenges, and guiding treatment. The Journal of Clinical Endocrinology & Metabolism. 2021; 106 (3): e1071–83.
Hoeger KM, Dokras A, Piltonen T. Update on PCOS: consequences, challenges, and guiding treatment. The Journal of Clinical Endocrinology & Metabolism. 2021; 106 (3): e1071–83.
Carmina E, Lobo RA. Polycystic ovary syndrome (PCOS): arguably the most common endocrinopathy is associated with significant morbidity in women. The journal of clinical endocrinology & metabolism. 1999; 84 (6): 1897–9.
Kahsar-Miller MD, Nixon C, Boots LR, Go RC, Azziz R. Prevalence of polycystic ovary syndrome (PCOS) in first-degree relatives of patients with PCOS. Fertility and sterility. 2001; 75 (1): 53–8.
Hart R, Doherty DA. The potential implications of a PCOS diagnosis on a woman’s long-term health using data linkage. The journal of clinical endocrinology & metabolism. 2015 Mar; 100 (3): 911–9.
Legro R. Diagnosis and treatment of polycystic ovary syndrome (PCOS): An interview with Richard Legro. BMC medicine. 2015; 13 (1): 1–5.
DeUgarte CM, Bartolucci AA, Azziz R. Prevalence of insulin resistance in the polycystic ovary syndrome using the homeostasis model assessment. Fertility and sterility. 2005; 83 (5): 1454–60.
Dumesic DA, Oberfield SE, Stener–Victorin E, Marshall JC, Laven JS, Legro RS. Scientific statement on the diagnostic criteria, epidemiology, pathophysiology, and molecular genetics of polycystic ovary syndrome. Endocrine reviews. 2015; 36 (5): 487–525.
Day F, Karaderi T, Jones MR, Meun C, He C, Drong A, Kraft P, Lin N, Huang H, Broer L, Magi R. Large-scale genome-wide meta-analysis of polycystic ovary syndrome suggests shared genetic architecture for different diagnosis criteria. PLoS genetics. 2018; 14 (12): e1007813.
Azziz R, Carmina E, Chen Z, Dunaif A, Laven JS, Legro RS, Lizneva D, Natterson-Horowtiz B, Teede HJ, Yildiz BO. Polycystic ovary syndrome. Nature reviews Disease primers. 2016; 2 (1): 1–8.
Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W, Janssen OE, Legro RS, Norman RJ, Taylor AE, Witchel SF. The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertility and sterility. 2009; 91 (2): 456–88.
Legro RS, Driscoll D, Strauss JF, Fox J, Dunaif A. Evidence for a genetic basis for hyperandrogenemia in polycystic ovary syndrome. Proceedings of the National Academy of Sciences. 1998; 95 (25): 14956–60.
Brassard M, AinMelk Y, Baillargeon JP. Basic infertility including polycystic ovary syndrome. Medical Clinics of North America. 2008; 92 (5): 1163–92.
Briden L, Shirin S, Prior JC. The central role of ovulatory disturbances in the etiology of androgenic polycystic ovary syndrome (PCOS)—Evidence for treatment with cyclic progesterone. Drug Discovery Today: Disease Models. 2020; 32: 71–82.
Adams JM, Taylor AE, Crowley Jr WF, Hall JE. Polycystic ovarian morphology with regular ovulatory cycles: insights into the pathophysiology of polycystic ovarian syndrome. The Journal of Clinical Endocrinology & Metabolism. 2004; 89 (9): 4343–50.
Garg D, Tal R. The role of AMH in the pathophysiology of polycystic ovarian syndrome. Reproductive biomedicine online. 2016; 33 (1): 15–28.
Diamanti-Kandarakis E. Polycystic ovarian syndrome: pathophysiology, molecular aspects and clinical implications. Expert Reviews in molecular medicine. 2008; 10.
Balen A. The pathophysiology of polycystic ovary syndrome: trying to understand PCOS and its endocrinology. Best practice & research clinical obstetrics & gynaecology. 2004; 18 (5): 685–706.
Ibáñez L, Oberfield SE, Witchel S, Auchus RJ, Chang RJ, Codner E, et al. An international consortium update: pathophysiology, diagnosis, and treatment of polycystic ovarian syndrome in adolescence. Hormone Research in Paediatrics. 2017; 88 (6): 371–95.
Shorakae S, Ranasinha S, Abell S, Lambert G, Lambert E, de Courten B, et al. Inter‐related effects of insulin resistance, hyperandrogenism, sympathetic dysfunction and chronic inflammation in PCOS. Clinical endocrinology. 2018; 89 (5): 628–33.
Merhi Z, Kandaraki EA, Diamanti-Kandarakis E. Implications and future perspectives of AGEs in PCOS pathophysiology. Trends in Endocrinology & Metabolism. 2019; 30 (3): 150–62.
Catteau-Jonard S, Dewailly D. Pathophysiology of polycystic ovary syndrome: the role of hyperandrogenism. Polycystic ovary syndrome. 2013; 40: 22–7.
Dumont A, Robin G, Dewailly D. Anti-Müllerian hormone in the pathophysiology and diagnosis of polycystic ovarian syndrome. Current Opinion in Endocrinology, Diabetes and Obesity. 2018; 25 (6): 377–84.
Khadilkar SS. Polycystic ovarian syndrome: is it time to rename PCOS to ha-pods? The Journal of Obstetrics and Gynecology of India. 2016; 66 (2): 81–7.
Zacur HA. Epidemiology, clinical manifestations, and pathophysiology of polycystic ovary syndrome. Advanced studies in medicine. 2003; 3 (8 A): S733–9.
Nidhi R, Padmalatha V, Nagarathna R, Amritanshu R. Prevalence of polycystic ovarian syndrome in Indian adolescents. Journal of pediatric and adolescent gynecology.2011; 24 (4): 223–227.
Tehrani FR, Simbar M, Tohidi M, Hosseinpanah F, Azizi F. The prevalence of polycystic ovary syndrome in a community sample of Iranian population: Iranian PCOS prevalence study. Reproductive Biology and Endocrinology. 2011; 9 (1): 1–7.
Al Khaduri M, Al Farsi Y, Al Najjar TA, Gowri V. Hospital-based prevalence of polycystic ovarian syndrome among Omani women. Middle East Fertility Society Journal. 2014; 19 (2): 135–8.
Alvarez-Blasco F, Botella-Carretero JI, San Millán JL, Escobar-Morreale HF. Prevalence and characteristics of the polycystic ovary syndrome in overweight and obese women. Archives of internal medicine. 2006; 166 (19): 2081–6.
Radha P, Devi RS, Madhavi J. Comparative study of prevalence of polycystic ovarian syndrome in rural and urban population. Journal of Advanced Medical and Dental Sciences Research. 2016; 4 (2): 90.
Hall JE, Taylor AE, Hayes FJ, Crowley WF. Insights into hypothalamic-pituitary dysfunction in polycystic ovary syndrome. Journal of endocrinological investigation. 1998; 21 (9): 602–11.
Baskind NE, Balen AH. Hypothalamic–pituitary, ovarian and adrenal contributions to polycystic ovary syndrome. Best Practice & Research Clinical Obstetrics & Gynaecology. 2016; 37: 80–97.
Azziz R, Black V, Hines GA, Fox LM, Boots LR. Adrenal androgen excess in the polycystic ovary syndrome: sensitivity and responsivity of the hypothalamic-pituitary-adrenal axis. The Journal of Clinical Endocrinology & Metabolism. 1998; 83 (7): 2317–23.
Doi SA, Towers PA, Scott CJ, Al-Shoumer KA. PCOS: an ovarian disorder that leads to dysregulation in the hypothalamic–pituitary–adrenal axis? European Journal of Obstetrics & Gynecology and Reproductive Biology. 2005; 118 (1): 4–16.
Barontini M, Garcı́a-Rudaz MC, Veldhuis JD. Mechanisms of hypothalamic-pituitary-gonadal disruption in polycystic ovarian syndrome. Archives of medical research. 2001; 32 (6): 544–52.
Kettel LM, Roseff SJ, Berga SL, Mortola JF, Yen SS. Hypothalamic-pituitary-ovarian response to clomiphene citrate in women with polycystic ovary syndrome. Fertility and sterility. 1993; 59 (3): 532–8.
Nidhi R, Padmalatha V, Nagarathna R, Amritanshu R. Effect of holistic yoga program on anxiety symptoms in adolescent girls with polycystic ovarian syndrome: A randomized control trial. International journal of yoga. 2012; 5 (2): 112.
Gill H, Tiwari P, Dabadghao P. Prevalence of polycystic ovary syndrome in young women from North India: A Community-based study. Indian journal of endocrinology and metabolism. 2012; 16 (Suppl 2): S389.
Balaji S, Amadi C, Prasad S, Bala Kasav J, Upadhyay V, Singh AK, Surapaneni KM, Joshi A. Urban rural comparisons of polycystic ovary syndrome burden among adolescent girls in a hospital setting in India. BioMed research international. 2015; 2015: 158951
Diamanti-Kandarakis E, Kouli C, Tsianateli T, Bergiele A. Therapeutic effects of metformin on insulin resistance and hyperandrogenism in polycystic ovary syndrome. European Journal of Endocrinology. 1998; 138 (3): 269–74.
Cassar S, Misso ML, Hopkins WG, Shaw CS, Teede HJ, Stepto NK. Insulin resistance in polycystic ovary syndrome: a systematic review and meta-analysis of euglycaemic–hyperinsulinaemic clamp studies. Human reproduction. 2016; 31 (11): 2619–31.
Diamanti-Kandarakis E, Papavassiliou AG. Molecular mechanisms of insulin resistance in polycystic ovary syndrome. Trends in molecular medicine. 2006; 12 (7): 324–32.
Azziz R. Polycystic ovary syndrome, insulin resistance, and molecular defects of insulin signaling. The Journal of Clinical Endocrinology & Metabolism. 2002; 87 (9): 4085–7.
Marshall JC, Dunaif A. Should all women with PCOS be treated for insulin resistance? Fertility and sterility. 2012; 97 (1): 18–22.
Holte J. Disturbances in insulin secretion and sensitivity in women with the polycystic ovary syndrome. Baillière's clinical endocrinology and metabolism. 1996; 10 (2): 221–47.
Zehravi M, Maqbool M, Ara I. Correlation between obesity, gestational diabetes mellitus, and pregnancy outcomes: an overview. International Journal of Adolescent Medicine and Health. 2021; 33 (6): 339–345.
Barber TM, Dimitriadis GK, Andreou A, Franks S. Polycystic ovary syndrome: insight into pathogenesis and a common association with insulin resistance. Clinical Medicine. 2016 Jun; 16 (3): 262–6.
Fedorcsák P, Dale PO, Storeng R, Tanbo T, Åbyholm T. The impact of obesity and insulin resistance on the outcome of IVF or ICSI in women with polycystic ovarian syndrome. Human Reproduction. 2001; 16 (6): 1086–91.
Tosi F, Bonora E, Moghetti P. Insulin resistance in a large cohort of women with polycystic ovary syndrome: a comparison between euglycaemic-hyperinsulinaemic clamp and surrogate indexes. Human Reproduction. 2017; 32 (12): 2515–21.
Laughlin GA, Morales AJ, Yen SS. Serum leptin levels in women with polycystic ovary syndrome: the role of insulin resistance/hyperinsulinemia. The Journal of Clinical Endocrinology & Metabolism. 1997; 82 (6): 1692–6.
Pugeat M, Ducluzeau PH. Insulin resistance, polycystic ovary syndrome and metformin. Drugs. 1999; 58 (1): 41–6.
Prelevic GM. Insulin resistance in polycystic ovary syndrome. Current opinion in obstetrics & gynecology. 1997; 9 (3): 193–201.
Dahan MH, Reaven G. Relationship among obesity, insulin resistance, and hyperinsulinemia in the polycystic ovary syndrome. Endocrine. 2019; 64 (3): 685–9.
Morin-Papunen LC, Vauhkonen I, Koivunen RM, Ruokonen A, Tapanainen JS. Insulin sensitivity, insulin secretion, and metabolic and hormonal parameters in healthy women and women with polycystic ovarian syndrome. Human reproduction. 2000; 15 (6): 1266–74.
Zimmermann S, Phillips RA, Dunaif A, Finegood DT, Wilkenfeld C, Ardeljan M, Gorlin R, Krakoff LR. Polycystic ovary syndrome: lack of hypertension despite profound insulin resistance. The Journal of Clinical Endocrinology & Metabolism. 1992; 75 (2): 508–13.
Deswal R, Yadav A, Dang AS. Sex hormone binding globulin-an important biomarker for predicting PCOS risk: A systematic review and meta-analysis. Systems biology in reproductive medicine. 2018; 64 (1): 12–24.
Martínez-García MÁ, Gambineri A, Alpanes M, Sanchon R, Pasquali R, Escobar-Morreale HF. Common variants in the sex hormone-binding globulin gene (SHBG) and polycystic ovary syndrome (PCOS) in Mediterranean women. Human reproduction. 2012; 27 (12): 3569–76.
Xita N, Tsatsoulis A, Chatzikyriakidou A, Georgiou I. Association of the (TAAAA) n repeat polymorphism in the sex hormone-binding globulin (SHBG) gene with polycystic ovary syndrome and relation to SHBG serum levels. The Journal of Clinical Endocrinology & Metabolism. 2003; 88 (12): 5976–80.
Cibula D, Fanta M, Vrbikova J, Stanicka S, Dvorakova K, Hill M, Skrha J, Zivny J, Skrenkova J. The effect of combination therapy with metformin and combined oral contraceptives (COC) versus COC alone on insulin sensitivity, hyperandrogenaemia, SHBG and lipids in PCOS patients. Human Reproduction. 2005; 20 (1): 180–4.
Li Y, Fang L, Yan Y, Wang Z, Wu Z, Jia Q, Cheng JC, Sun YP. Association between human SHBG gene polymorphisms and risk of PCOS: a meta-analysis. Reproductive BioMedicine Online. 2021; 42 (1): 227–36.
Jayagopal V, Kilpatrick ES, Jennings PE, Hepburn DA, Atkin SL. The biological variation of testosterone and sex hormone-binding globulin (SHBG) in polycystic ovarian syndrome: implications for SHBG as a surrogate marker of insulin resistance. The Journal of Clinical Endocrinology & Metabolism. 2003; 88 (4): 1528–33.
Abu-Hijleh TM, Gammoh E, Al-Busaidi AS, Malalla ZH, Madan S, Mahmood N, Almawi WY. Common variants in the sex hormone-binding globulin (SHBG) gene influence SHBG levels in women with polycystic ovary syndrome. Annals of Nutrition and Metabolism. 2016; 68 (1): 66–74.
Calzada M, López N, Noguera JA, Mendiola J, Hernández AI, Corbalán S, Sanchez M, Torres AM. AMH in combination with SHBG for the diagnosis of polycystic ovary syndrome. Journal of Obstetrics and Gynaecology. 2019; 39 (8): 1130–6.
Fan W, Li S, Chen Q, Huang Z. Association between the (TAAAA) n SHBG polymorphism and PCOS: a systematic review and meta-analysis. Gynecological Endocrinology. 2013; 29 (7): 645–50.
Ferk P, Teran N, Gersak K. The (TAAAA) n microsatellite polymorphism in the SHBG gene influences serum SHBG levels in women with polycystic ovary syndrome. Human reproduction. 2007; 22 (4): 1031–6.
Wickham III EP, Ewens KG, Legro RS, Dunaif A, Nestler JE, Strauss III JF. Polymorphisms in the SHBG gene influence serum SHBG levels in women with polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism. 2011; 96 (4): E719–27.
Wassell J, Michail M, Soliman N, Wardle PG. The value of sex hormone binding globulin (SHBG) in predicting treatment response in polycystic ovary syndrome (PCOS). Clinical Laboratory. 2011; 57 (1–2): 95–8.
Schmidt J, Brännström M, Landin-Wilhelmsen K, Dahlgren E. Reproductive hormone levels and anthropometry in postmenopausal women with polycystic ovary syndrome (PCOS): a 21-year follow-up study of women diagnosed with PCOS around 50 years ago and their age-matched controls. The Journal of Clinical Endocrinology & Metabolism. 2011; 96 (7): 2178–85.
Chen MJ, Yang WS, Yang JH, Hsiao CK, Yang YS, Ho HN. Low sex hormone-binding globulin is associated with low high-density lipoprotein cholesterol and metabolic syndrome in women with PCOS. Human Reproduction. 2006; 21 (9): 2266–71.
Panda PK, Rane R, Ravichandran R, Singh S, Panchal H. Genetics of PCOS: A systematic bioinformatics approach to unveil the proteins responsible for PCOS. Genomics data. 2016; 8: 52–60.
Šimková M, Vítků J, Kolatorova L, Vrbikova J, Vosatkova M, Včelák J, Dušková M. Endocrine disruptors, obesity, and cytokines-how relevant are they to PCOS? Physiological research. 2020; 69 (Suppl 2): S279.
Gambineri A, Patton L, Altieri P, Pagotto U, Pizzi C, Manzoli L, Pasquali R. Polycystic ovary syndrome is a risk factor for type 2 diabetes: results from a long-term prospective study. Diabetes. 2012; 61 (9): 2369–74.
Chen C, Smothers JC, Lange A, Nestler JE, Strauss III JF, Wickham III EP. Sex hormone-binding globulin genetic variation: associations with type 2 diabetes mellitus and polycystic ovary syndrome. Minerva endocrinologica. 2010; 35 (4): 271.
Wijeyaratne CN, Balen AH, Barth JH, Belchetz PE. Clinical manifestations and insulin resistance (IR) in polycystic ovary syndrome (PCOS) among South Asians and Caucasians: is there a difference? Clinical endocrinology. 2002; 57 (3): 343–50.
Ovalle F, Azziz R. Insulin resistance, polycystic ovary syndrome, and type 2 diabetes mellitus. Fertility and sterility. 2002; 77 (6): 1095–105.
Conn JJ, Jacobs HS, Conway GS. The prevalence of polycystic ovaries in women with type 2 diabetes mellitus. Clinical endocrinology. 2000; 52 (1): 81–6.
Ollila MM, West S, Keinänen-Kiukaanniemi S, Jokelainen J, Auvinen J, Puukka K, Ruokonen A, Järvelin MR, Tapanainen JS, Franks S, Piltonen TT. Overweight and obese but not normal weight women with PCOS are at increased risk of Type 2 diabetes mellitus—a prospective, population-based cohort study. Human Reproduction. 2017 Feb 1; 32 (2): 423–31.
Carreau AM, Baillargeon JP. PCOS in adolescence and type 2 diabetes. Current diabetes reports. 2015; 15 (1): 1–9.
Barber TM, Bennett AJ, Groves CJ, Sovio U, Ruokonen A, Martikainen H, Pouta A, Hartikainen AL, Elliott P, Wass JA, Järvelin MR. Disparate genetic influences on polycystic ovary syndrome (PCOS) and type 2 diabetes revealed by a lack of association between common variants within the TCF7L2 gene and PCOS. Diabetologia. 2007; 50 (11): 2318–22.
Tomlinson J, Millward A, Stenhouse E, Pinkney J. Type 2 diabetes and cardiovascular disease in polycystic ovary syndrome: what are the risks and can they be reduced? Diabetic Medicine. 2010 May; 27 (5): 498–515.
Corbould A. Insulin resistance in skeletal muscle and adipose tissue in polycystic ovary syndrome: are the molecular mechanisms distinct from type 2 diabetes? Panminerva medica. 2008; 50 (4): 279–94.
Kakoly NS, Earnest A, Teede HJ, Moran LJ, Joham AE. The impact of obesity on the incidence of type 2 diabetes among women with polycystic ovary syndrome. Diabetes care. 2019; 42 (4): 560–7.
Galazis N, Afxentiou T, Xenophontos M, Diamanti-Kandarakis E, Atiomo W. Proteomic biomarkers of type 2 diabetes mellitus risk in women with polycystic ovary syndrome. Eur J Endocrinol. 2013; 168 (2): R33–43.
Kosova G, Urbanek M. Genetics of the polycystic ovary syndrome. Molecular and cellular endocrinology. 2013; 373 (1–2): 29–38.
Abdalla MA, Deshmukh H, Atkin S, Sathyapalan T. A review of therapeutic options for managing the metabolic aspects of polycystic ovary syndrome. Therapeutic Advances in Endocrinology and Metabolism. 2020; 11: 2042018820938305.
Tal R, Seifer DB, Khanimov M, Malter HE, Grazi RV, Leader B. Characterization of women with elevated anti-Müllerian hormone levels (AMH): correlation of AMH with polycystic ovarian syndrome phenotypes and assisted reproductive technology outcomes. American journal of obstetrics and gynecology. 2014; 211 (1): 59–e1.
Homburg R, Crawford G. The role of AMH in anovulation associated with PCOS: a hypothesis. Human Reproduction. 2014; 29 (6): 1117–21.
Evliyaoglu O, Imöhl M, Weiskirchen R, van Helden J. Age-specific reference values improve the diagnostic performance of AMH in polycystic ovary syndrome. Clinical Chemistry and Laboratory Medicine (CCLM). 2020; 58 (8): 1291–301.
Mohammad MB, Seghinsara AM. Polycystic ovary syndrome (PCOS), diagnostic criteria, and AMH. Asian Pacific journal of cancer prevention: APJCP. 2017; 18 (1): 17.
Dewailly D, Gronier H, Poncelet E, Robin G, Leroy M, Pigny P, Duhamel A, Catteau-Jonard S. Diagnosis of polycystic ovary syndrome (PCOS): revisiting the threshold values of follicle count on ultrasound and of the serum AMH level for the definition of polycystic ovaries. Human reproduction. 2011; 26 (11): 3123–9.
Maqbool M, Khan M, Mohammad M, Adesina MA, Fekadu G. Awareness about reproductive health in adolescents and youth: a review. Journal of Applied Pharmaceutical Sciences and Research. 2019; 2 (3): 1–5.
Anderson RA, Groome NP, Baird DT. Inhibin A and inhibin B in women with polycystic ovarian syndrome during treatment with FSH to induce mono‐ovulation. Clinical endocrinology. 1998; 48 (5): 577–84.
Tsigkou A, Luisi S, De Leo V, Patton L, Gambineri A, Reis FM, Pasquali R, Petraglia F. High serum concentration of total inhibin in polycystic ovary syndrome. Fertility and sterility. 2008; 90 (5): 1859–63.
Sahmay S, Aydin Y, Oncul M, Senturk LM. Diagnosis of polycystic ovary syndrome: AMH in combination with clinical symptoms. Journal of assisted reproduction and genetics. 2014; 31 (2): 213–20.
Stracquadanio M, Ciotta L, Palumbo MA. Relationship between serum anti-Mullerian hormone and intrafollicular AMH levels in PCOS women. Gynecological Endocrinology. 2018; 34 (3): 223–8.
Wiweko B, Maidarti M, Priangga MD, Shafira N, Fernando D, Sumapraja K, Natadisastra M, Hestiantoro A. Anti-mullerian hormone as a diagnostic and prognostic tool for PCOS patients. Journal of assisted reproduction and genetics. 2014; 31 (10): 1311–6.
Leerasiri P, Wongwananuruk T, Indhavivadhana S, Techatraisak K, Rattanachaiyanont M, Angsuwathana S. Correlation of clinical and biochemical hyperandrogenism in Thai women with polycystic ovary syndrome. Journal of Obstetrics and Gynaecology Research. 2016; 42 (6): 678–83.
Quinn M, Shinkai K, Pasch L, Kuzmich L, Cedars M, Huddleston H. Prevalence of androgenic alopecia in patients with polycystic ovary syndrome and characterization of associated clinical and biochemical features. Fertility and sterility. 2014; 101 (4): 1129–34.
Rellini AH, Stratton N, Tonani S, Santamaria V, Brambilla E, Nappi RE. Differences in sexual desire between women with clinical versus biochemical signs of hyperandrogenism in polycystic ovarian syndrome. Hormones and behavior. 2013; 63 (1): 65–71.
Michelmore KF, Balen AH, Dunger DB, Vessey MP. Polycystic ovaries and associated clinical and biochemical features in young women. Clinical endocrinology. 1999; 51 (6): 779–86.
Hart R, Hickey M, Franks S. Definitions, prevalence and symptoms of polycystic ovaries and polycystic ovary syndrome. Best Practice & Research Clinical Obstetrics & Gynaecology. 2004; 18 (5): 671–83.
Yildiz BO. Diagnosis of hyperandrogenism: clinical criteria. Best practice & research Clinical endocrinology & metabolism. 2006; 20 (2): 167–76.
Amiri M, Kabir A, Nahidi F, Shekofteh M, Ramezani Tehrani F. Effects of combined oral contraceptives on the clinical and biochemical parameters of hyperandrogenism in patients with polycystic ovary syndrome: a systematic review and meta-analysis. The European Journal of Contraception & Reproductive Health Care. 2018; 23 (1): 64–77.
Escobar-Morreale HF, Sanchon R, San Millán JL. A prospective study of the prevalence of nonclassical congenital adrenal hyperplasia among women presenting with hyperandrogenic symptoms and signs. The Journal of Clinical Endocrinology & Metabolism. 2008; 93 (2): 527–33.
Liou TH, Yang JH, Hsieh CH, Lee CY, Hsu CS, Hsu MI. Clinical and biochemical presentations of polycystic ovary syndrome among obese and nonobese women. Fertility and sterility. 2009; 92 (6): 1960–5.
Janjic D. Android-type obesity and gynecoid-type obesity. Praxis 1996; 85: 1578–83.
Vague J, Vague P, Tramoni M, Vialettes B, Mercier P. Obesity and diabetes. Acta diabetologia latina. 1980; 17: 87–99.
Bjorntorp P. Classification of obese patients and complications related to the distribution of surplus fat. American journal of clinical nutrition (USA) 1987.
Barber TM, McCarthy MI, Wass JA, Franks S. Obesity and polycystic ovary syndrome. Clinical endocrinology. 2006; 65 (2): 137–45..
Horejsi R, Möller R, Rackl S, Giuliani A, Freytag U, Crailsheim K, Sudi K, Tafeit E. Android subcutaneous adipose tissue topography in lean and obese women suffering from PCOS: comparison with type 2 diabetic women. American Journal of Physical Anthropology: The Official Publication of the American Association of Physical Anthropologists. 2004; 124 (3): 275–81.
Hoeger K. Obesity and weight loss in polycystic ovary syndrome. Obstetrics and gynecology clinics of North America. 2001; 28 (1): 85–97.
Ahmadi A, Akbarzadeh M, Mohammadi F, Akbari M, Jafari B, Tolide-Ie HR. Anthropometric characteristics and dietary pattern of women with polycystic ovary syndrome. Indian journal of endocrinology and metabolism. 2013; 17 (4): 672.
Zehravi M, Maqbool M, Ara I. Polycystic ovary syndrome and reproductive health of women: a curious association. International journal of adolescent medicine and health. 2021; 33 (6): 333–7.
Maqbool M, Nasir N, Mustafa S. Polycystic in ovarian syndrome and its various treatment strategies. INDO AMERICAN JOURNAL OF PHARMACEUTICAL SCIENCES. 2018; 5 (9): 8470–8.
Ara I, Mohd M, Maqbool M, Hajam TA. Polycystic Ovary syndrome: A disorder of alarming proportion.
Lefebvre P, Bringer J, Renard E, Boulet F, Clouet S, Jaffiol C. Influences of weight, body fat patterning and nutrition on the management of PCOS. Human reproduction. 1997; 12 (suppl_1): 72–81.
Majumdar A, Singh TA. Comparison of clinical features and health manifestations in lean vs. obese Indian women with polycystic ovarian syndrome. Journal of human reproductive sciences. 2009; 2 (1): 12.
Elkholi DG, Nagy HM. The effects of adipocytokines on the endocrino-metabolic features and obstetric outcome in pregnant obese women with polycystic ovary syndrome. Middle East Fertility Society Journal. 2014; 19 (4): 293–302.
Akbarzadeh M, Behbahani BM, Naderi T, Dabbaghmaneh M, Zare N. The survey of central obesity and BMI associated with different phenotypes of polycystic ovary syndrome in adolescents. International Journal of Africa Nursing Sciences. 2015; 3: 82–5.
Diamanti-Kandarakis E, Christakou CD. Insulin resistance in PCOS. Diagnosis and management of polycystic ovary syndrome. 2009: 35–61.
Venkatesan AM, Dunaif A, Corbould A. Insulin resistance in polycystic ovary syndrome: progress and paradoxes. Recent progress in hormone research. 2001; 56: 295–308.
Corbould A, Kim YB, Youngren JF, Pender C, Kahn BB, Lee A, Dunaif A. Insulin resistance in the skeletal muscle of women with PCOS involves intrinsic and acquired defects in insulin signaling. American Journal of Physiology-Endocrinology and Metabolism. 2005; 288 (5): E1047–54.
Moghetti P, Tosi F. Insulin resistance and PCOS: chicken or egg? Journal of Endocrinological Investigation. 2020: 1–12.
Robinson S, Henderson AD, Gelding SV, Kiddy D, Niththyananthan R, Bush A, Richmond W, Johnston DG, Franks S. Dyslipidaemia is associated with insulin resistance in women with polycystic ovaries. Clinical endocrinology. 1996; 44 (3): 277–84.
Stepto NK, Hiam D, Gibson-Helm M, Cassar S, Harrison CL, Hutchison SK, Joham AE, Canny BJ, Moreno-Asso A, Strauss BJ, Hatzirodos N. Exercise and insulin resistance in PCOS: muscle insulin signalling and fibrosis. Endocrine connections. 2020; 9 (4): 346–59.
Ehrmann DA. Metabolic dysfunction in PCOS: relationship to obstructive sleep apnea. Steroids. 2012; 77 (4): 290–4.
Moran LJ, Norman RJ, Teede HJ. Metabolic risk in PCOS: phenotype and adiposity impact. Trends in Endocrinology & Metabolism. 2015; 26 (3): 136–43.
Siemienowicz KJ, Coukan F, Franks S, Rae MT, Duncan WC. Aberrant subcutaneous adipogenesis precedes adult metabolic dysfunction in an ovine model of polycystic ovary syndrome (PCOS). Molecular and Cellular Endocrinology. 2021; 519: 111042.
Broekmans FJ, Knauff EA, Valkenburg O, Laven JS, Eijkemans MJ, Fauser BC. PCOS according to the Rotterdam consensus criteria: change in prevalence among WHO‐II anovulation and association with metabolic factors. BJOG: An International Journal of Obstetrics & Gynaecology. 2006; 113 (10): 1210–7.
Franks S. Animal models and the developmental origins of polycystic ovary syndrome: increasing evidence for the role of androgens in programming reproductive and metabolic dysfunction. Oxford Academic.2012; 153 (6): 2536–2538.
Sanchez-Garrido MA, Tena-Sempere M. Metabolic dysfunction in polycystic ovary syndrome: Pathogenic role of androgen excess and potential therapeutic strategies. Molecular metabolism. 2020; 35: 100937.
Di Sarra D, Tosi F, Bonin C, Fiers T, Kaufman JM, Signori C, Zambotti F, Dall'Alda M, Caruso B, Zanolin ME, Bonora E. Metabolic inflexibility is a feature of women with polycystic ovary syndrome and is associated with both insulin resistance and hyperandrogenism. The Journal of Clinical Endocrinology & Metabolism. 2013; 98 (6): 2581–8.
Witchel SF, Teede HJ, Peña AS. Curtailing pcos. Pediatric research. 2020; 87 (2): 353–61.
Dunaif A, Fauser BC. Renaming PCOS—a two-state solution. The Journal of Clinical Endocrinology & Metabolism. 2013; 98 (11): 4325–8.
Landay M, Huang A, Azziz R. Degree of hyperinsulinemia, independent of androgen levels, is an important determinant of the severity of hirsutism in PCOS. Fertility and sterility. 2009; 92 (2): 643–7.
Glintborg D, Andersen M. An update on the pathogenesis, inflammation, and metabolism in hirsutism and polycystic ovary syndrome. Gynecological endocrinology. 2010; 26 (4): 281–96.
Mara Spritzer P, Rocha Barone C, Bazanella de Oliveira F. Hirsutism in polycystic ovary syndrome: pathophysiology and management. Current pharmaceutical design 2016; 22 (36): 5603–13.
Lobo RA, Goebelsmann U, Horton R. Evidence for the importance of peripheral tissue events in the development of hirsutism in polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism 1983; 57 (2): 393–7.
Falsetti L, Gambera A, Andrico S, Sartori E. Acne and hirsutism in polycystic ovary syndrome: clinical, endocrine–metabolic and ultrasonographic differences. Gynecological endocrinology 2002; 16 (4): 275–84.
Archer JS, Chang RJ. Hirsutism and acne in polycystic ovary syndrome. Best Practice & Research Clinical Obstetrics & Gynaecology 2004; 18 (5): 737–54.
Cupisti S, Dittrich R, Binder H, Kajaia N, Hoffmann I, Maltaris T, et al. Influence of body mass index on measured and calculated androgen parameters in adult women with hirsutism and PCOS. Experimental and clinical endocrinology & diabetes 2007; 115 (6): 380–6.
Chuan SS, Chang RJ. Polycystic ovary syndrome and acne. Skin therapy letter 2010; 15 (10): 1–4.
Shaw JC. Acne. American journal of clinical dermatology 2002; 3 (8): 571–8.
Maluki AH. The frequency of polycystic ovary syndrome in females with resistant acne vulgaris. Journal of cosmetic dermatology 2010; 9 (2): 142–8.
Bunker C, Newton JA, Kilborn J, Patel A, Conway G, Jacobs H, et al. Most women with acne have polycystic ovaries. British Journal of Dermatology 1989; 121 (6): 675–80.
Lichtenberger R, Simpson MA, Smith C, Barker J, Navarini AA. Genetic architecture of acne vulgaris. Journal of the European Academy of Dermatology and Venereology 2017; 31 (12): 1978–90.
Abdullah Z, Masood Q, Hassan I, Kirmani O. Hormonal profile and polycystic ovaries in women with acne vulgaris. Indian Journal of Dermatology, Venereology, and Leprology 2013; 79 (3): 422.
Walton S, Cunliffe W, Keczkes K, Early A, McGarrigle H, Katz M, et al. Clinical, ultrasound and hormonal markers of androgenicity in acne vulgaris. British Journal of Dermatology 1995; 133 (2): 249–53.
Cela E, Robertson C, Rush K, Kousta E, White DM, Wilson H, et al. Prevalence of polycystic ovaries in women with androgenic alopecia. European Journal of Endocrinology 2003; 149 (5): 439–42.
Starka L, Duskova M, Vrbikova J, Hill M. Premature androgenic alopecia and insulin resistance. Male equivalent of polycystic ovary syndrome? Endocrine regulations 2005; 39 (4): 127.
Lie C, Liew CF, Oon HH. Alopecia and the metabolic syndrome. Clinics in dermatology 2018; 36 (1): 54–61.
Goodman NF, Cobin RH, Futterweit W, Glueck JS, Legro RS, Carmina E. American Association of Clinical Endocrinologists, American College of Endocrinology, and androgen excess and PCOS society disease state clinical review: guide to the best practices in the evaluation and treatment of polycystic ovary syndrome-part 1. Endocrine Practice. 2015; 21 (11): 1291–300.
Musmar S, Afaneh A, Mo'alla H. Epidemiology of polycystic ovary syndrome: a cross sectional study of university students at An-Najah national university-Palestine. Reproductive Biology and Endocrinology. 2013; 11 (1): 1–6.
Hardy TS, Norman RJ. Diagnosis of adolescent polycystic ovary syndrome. Steroids 2013; 78 (8): 751–4.
Mukena M. My silent battle with PCOS. Sister Namibia. 2016; 28 (4): 30–2.
Langaker M. Obesity in the Female Patient with a focus on PCOS.
Linden Hirschberg A, Naessen S, Stridsberg M, Byström B, Holte J. Impaired cholecystokinin secretion and disturbed appetite regulation in women with polycystic ovary syndrome. Gynecological Endocrinology. 2004; 19 (2): 79–87..
Bidzińska-Speichert B, Lenarcik A, Tworowska-Bardzińska U, Ślęzak R, Bednarek-Tupikowska G, Milewicz A. Pro12Ala PPAR γ2 gene polymorphism in PCOS women: the role of compounds regulating satiety. Gynecological Endocrinology. 2012; 28 (3): 195–8.
Arusoglu G, Koksal G, Cinar N, Tapan S, Aksoy DY, Yildiz BO. Basal and meal-stimulated ghrelin, PYY, CCK levels and satiety in lean women with polycystic ovary syndrome: effect of low-dose oral contraceptive. The Journal of Clinical Endocrinology & Metabolism. 2013; 98 (11): 4475–82.
Naessén S, Hirschberg AL. Aptitreglering vid PCOS. Polycystiskt ovarial syndrome (PCOS) 2008: 51.
Vrbíková J, Dvořáková K, Hill M, Včelák J, Stanická S, Vaňková M, Šrámková D, Vondra K, Bendlová B, Stárka L. Determinants of circulating adiponectin in women with polycystic ovary syndrome. Gynecologic and obstetric investigation. 2005; 60 (3): 155–61.
Groth SW. Adiponectin and polycystic ovary syndrome. Biological research for nursing 2010; 12 (1): 62–72.
Artimani T, Saidijam M, Aflatoonian R, Ashrafi M, Amiri I, Yavangi M, SoleimaniAsl S, Shabab N, Karimi J, Mehdizadeh M. Downregulation of adiponectin system in granulosa cells and low levels of HMW adiponectin in PCOS. Journal of assisted reproduction and genetics. 2016; 33 (1): 101–10.
Pasquali R, Stener‐Victorin E, Yildiz BO, Duleba AJ, Hoeger K, Mason H, Homburg R, Hickey T, Franks S, Tapanainen JS, Balen A. PCOS Forum: research in polycystic ovary syndrome today and tomorrow. Clinical endocrinology. 2011; 74 (4): 424–33.
Wickenheisser JK, Nelson-DeGrave VL, McAllister JM. Dysregulation of cytochrome P450 17α-hydroxylase messenger ribonucleic acid stability in theca cells isolated from women with polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism 2005; 90 (3): 1720–7.
Doi SA, Al-Zaid M, Towers PA, Scott CJ, Al-Shoumer KA. Steroidogenic alterations and adrenal androgen excess in PCOS. Steroids. 2006; 71 (9): 751–9.
Yildiz BO, Azziz R. The adrenal and polycystic ovary syndrome. Reviews in Endocrine and Metabolic Disorders 2007; 8 (4): 331–42.
Fruzzetti F, De Lorenzo D, Ricci C, Teti G. Ovarian influence on adrenal androgen secretion in polycystic ovary syndrome. Fertility and sterility 1995; 63 (4): 734–41.
Kumar A, Woods KS, Bartolucci AA, Azziz R. Prevalence of adrenal androgen excess in patients with the polycystic ovary syndrome (PCOS). Clinical endocrinology 2005; 62 (6): 644–9.
Moran C, Arriaga M, Arechavaleta-Velasco F, Moran S. Adrenal androgen excess and body mass index in polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism 2015; 100 (3): 942–50.
Wajchenberg BL, Achando SS, Okada H, Czeresnia CE, Peixoto S, Lima SS, Goldman J. Determination of the source (s) of androgen overproduction in hirsutism associated with polycystic ovary syndrome by simultaneous adrenal and ovarian venous catheterization. Comparison with the dexamethasone suppression test. The Journal of Clinical Endocrinology & Metabolism. 1986; 63 (5): 1204–10.
Fassnacht M, Schlenz N, Schneider SB, Wudy SA, Allolio B, Arlt W. Beyond adrenal and ovarian androgen generation: increased peripheral 5α-reductase activity in women with polycystic ovary syndrome. The Journal of Clinical Endocrinology & Metabolism 2003; 88 (6): 2760–6.
Ricardo Azziz M, Rittmaster RS, Fox LM, Bradley Jr EL, Potter HD, Boots LR. Role of the ovary in the adrenal androgen excess of hyperandrogenic women. Fertility and sterility 1998; 69 (5): 851–9.
Pasquali R, Casimirri F, Vicennati V. Weight control and its beneficial effect on fertility in women with obesity and polycystic ovary syndrome. Human Reproduction 1997; 12: 82–7.
Crosignani PG, Colombo M, Vegetti W, Somigliana E, Gessati A, Ragni G. Overweight and obese anovulatory patients with polycystic ovaries: parallel improvements in anthropometric indices, ovarian physiology and fertility rate induced by diet. Human reproduction 2003; 18 (9): 1928–32.
Fica S, Albu A, Constantin M, Dobri GA. Insulin resistance and fertility in polycystic ovary syndrome. Journal of medicine and life 2008; 1 (4): 415.
Legro RS, Dodson WC, Kunselman AR, Stetter CM, Kris-Etherton PM, Williams NI, et al. Benefit of delayed fertility therapy with preconception weight loss over immediate therapy in obese women with PCOS. The Journal of Clinical Endocrinology & Metabolism 2016; 101 (7): 2658–66.
Alchami A, O'Donovan O, Davies M. PCOS: diagnosis and management of related infertility. Obstetrics, Gynaecology & Reproductive Medicine 2015; 25: 279–82.
Homburg R. Polycystic ovary syndrome. Best Practice & Research Clinical Obstetrics & Gynaecology 2008; 22 (2): 261–74.
Cena H, Chiovato L, Nappi RE. Obesity, polycystic ovary syndrome, and infertility: A new avenue for GLP-1 receptor agonists. The Journal of Clinical Endocrinology & Metabolism 2020; 105 (8): e2695–e709.
Pasquali R, Gambineri A, Pagotto U. The impact of obesity on reproduction in women with polycystic ovary syndrome. BJOG: An International Journal of Obstetrics & Gynaecology 2006; 113 (10): 1148–59.
Norman RJ, Davies MJ, Lord J, Moran LJ. The role of lifestyle modification in polycystic ovary syndrome. Trends in Endocrinology & Metabolism 2002; 13 (6): 251–7.
Ruan X, Li M, Mueck AO. Why does Polycystic Ovary Syndrome (PCOS) need long-term management? Current pharmaceutical design 2018; 24 (39): 4685–92.
Mohd M, Maqbool M, Dar MA, Mushtaq I. Polycystic Ovary Syndrome, a modern epidemic: An overview. Journal of Drug Delivery and Therapeutics 2019; 9 (3): 641–4.
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