Abstract: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in
women. The clinical manifestation of PCOS varies from a mild menstrual disorder to severe
disturbance of reproductive and metabolic functions. Management of women with PCOS depends
on the symptoms. These could be ovulatory dysfunction-related infertility, menstrual disorders,
or androgen-related symptoms. Weight loss improves the endocrine profile and increases the
likelihood of ovulation and pregnancy. Normalization of menstrual cycles and ovulation could
occur with modest weight loss as little as 5% of the initial weight. The treatment of obesity
includes modifications in lifestyle (diet and exercise) and medical and surgical treatment.
In PCOS, anovulation relates to low follicle-stimulating hormone concentrations and the arrest
of antral follicle growth in the final stages of maturation. This can be treated with medications
such as clomiphene citrate, tamoxifen, aromatase inhibitors, metformin, glucocorticoids, or
gonadotropins or surgically by laparoscopic ovarian drilling. In vitro fertilization will remain
the last option to achieve pregnancy when others fail. Chronic anovulation over a long period of
time is also associated with an increased risk of endometrial hyperplasia and carcinoma, which
should be seriously investigated and treated. There are androgenic symptoms that will vary from
patient to patient, such as hirsutism, acne, and/or alopecia. These are troublesome presentations
to the patients and require adequate treatment. Alternative medicine has been emerging as one of
the commonly practiced medicines for different health problems, including PCOS. This review
underlines the contribution to the treatment of different symptoms. |
