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Issue 997 coverWomen's Health and Disease: Gynecologic and Reproductive Issues Volume 997 published November 2003
Ann. N.Y. Acad. Sci. 997: 307 (2003). doi: 10.1196/annals.1290.034
Copyright © 2003 by the New York Academy of Sciences
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Articles by BRUNI, V.
Articles by VANGELISTI, P.
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Articles by BRUNI, V.
Articles by VANGELISTI, P.
The Management of Polycystic Ovary Syndrome

VINCENZA BRUNI, METELLA DEI, VALENTINA PONTELLO AND PAOLO VANGELISTI

Department of Gynecology-Perinatology and Human Reproduction, University of Florence, Forence, Italy

Address for correspondence: Vincenza Bruni, Department of Gynecology-Perinatology and Human Reproduction, University of Florence, Forence, Italy. Voice: +39-055-4277551; fax: +39-055-4277552.
vbruni{at}unifi.it
Ann. N.Y. Acad. Sci. 997: 307-321 (2003).

It is well known that subjects with polycystic ovary syndrome (PCOS) show very variable clinical and biochemical aspects. Considering long-term repercussions, two main disturbances, not always strictly related, need to be countered: hyperandrogenism and insulin resistance, with compensatory hyperinsulinemia. The aim of this review is to summarize therapeutic perspectives for PCOS, starting from basic approach, such as weight reduction and changes in lifestyle. The benefits of long-term use of oral contrceptives and the criteria of choice of the estro-progestin combinations are discussed. With severe hyperandogenism, a pure antiandrogen should be added. The experiences with insulin-sensitizing drugs, especially metformin, are reviewed; while their beneficial role as an adjuvant to treatment of ovulatory infertility has been well established, the effects of a long-term treatment, especially in very young patients, are still under debate. Current studies are testing the results of combinations of different treatments at low dosage; randomized comparative trials on the long-term efficacy of these approaches have yet to be scheduled.

Key Words: polycystic ovary syndrome (PCOS) • insulin • obesity • infertility • menstruation • hyperandrogenism




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