Jin Peipei, Xie Yongyong
a Department of Traditional Chinese Medicine , The First Affiliated Hospital of Wenzhou Medical University , Wenzhou , China.
Gynecol Endocrinol. 2018 Apr;34(4):272-277. doi: 10.1080/09513590.2017.1395841. Epub 2017 Oct 31.
Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women, and it is the main cause of infertility in women of reproductive age due to anovulation. PCOS also increases the risk of diseases such as cardiovascular disease and type 2 diabetes in women with this disorder. The mechanism of pathogenesis is not clear, as it may be related to heredity, the environment and internal embryonic factors; thus, the treatment strategies remain unclear. This review summarizes current treatments for PCOS worldwide. Lifestyle modification (LSM) is considered the first-line treatment, regardless of fertility status, without the addition of metformin. Oral contraceptive (OC) pills should be used as a first-line treatment for long-term management for patients with no reproductive requirements. For patients with fertility requirements, ovulation therapy is an effective treatment. For refractory ovulation disorders, patients can choose from among the latest treatments, including ovarian hippocampal signal path block theory, the theory of leptin, inositol treatment, bilateral ovarian drilling to stimulate ovulation and assisted reproductive technology. Because current treatments cannot cure PCOS, lifelong administration is still the mainstream method of management; however, the optimal treatment plan needs further research and exploration.
多囊卵巢综合征(PCOS)是女性常见的内分泌紊乱疾病,是育龄期女性因无排卵导致不孕的主要原因。PCOS还会增加患有该疾病的女性患心血管疾病和2型糖尿病等疾病的风险。其发病机制尚不清楚,可能与遗传、环境和内在胚胎因素有关;因此,治疗策略仍不明确。本综述总结了目前全球范围内PCOS的治疗方法。生活方式调整(LSM)被认为是一线治疗方法,无论生育状况如何,无需加用二甲双胍。口服避孕药(OC)应作为无生育需求患者长期管理的一线治疗药物。对于有生育需求的患者,促排卵治疗是一种有效的治疗方法。对于难治性排卵障碍,患者可以从最新的治疗方法中选择,包括卵巢海马信号通路阻断理论、瘦素理论、肌醇治疗、双侧卵巢打孔促排卵和辅助生殖技术。由于目前的治疗方法无法治愈PCOS,终身给药仍是主要的管理方法;然而,最佳治疗方案仍需进一步研究和探索。