Telagarapu Venkata Madhavi Latha, Nallamothu Priyanka Devi, Telagarapu Venkata Nikhila, Nalluri Srikar Raja Chowdary, Nathani Saispoorthy, Kopani Chandu Priya, Yarraguntla Vishnu, Vyasalapu Sriharika
Internal Medicine, Private Practice, New York, USA.
Public Health, Miller School of Medicine, University of Miami, Miami, USA.
Cureus. 2025 Jul 18;17(7):e88216. doi: 10.7759/cureus.88216. eCollection 2025 Jul.
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder that significantly affects both obese and non-obese women of reproductive age. Besides genetic and epigenetic factors, obesity and insulin resistance (IR) play a key role in the pathogenesis of PCOS, contributing to its endocrine, reproductive, and metabolic manifestations. Even though metformin remains a well-established treatment in the management of PCOS, emerging therapies and integrative approaches warrant comparison. This narrative review aims to understand the pathophysiology of PCOS and compare the role of metformin with that of new emerging therapies, including sodium-glucose cotransporter-2 (SGLT-2) inhibitors, oral contraceptive pills (OCPs), inositol supplements, and lifestyle modifications, thereby empowering clinicians to provide personalized medicine based on each patient's unique presentation. This review explores the safety, efficacy, and clinical outcomes of these interventions on weight reduction, hormonal balance, menstrual regularity, and metabolic outcomes in both obese and non-obese women with PCOS.
多囊卵巢综合征（PCOS）是最常见的内分泌紊乱疾病，对育龄期肥胖和非肥胖女性均有显著影响。除遗传和表观遗传因素外，肥胖和胰岛素抵抗（IR）在PCOS的发病机制中起关键作用，导致其出现内分泌、生殖和代谢方面的表现。尽管二甲双胍仍是PCOS管理中公认的治疗方法，但新出现的疗法和综合治疗方法值得比较。本叙述性综述旨在了解PCOS的病理生理学，并比较二甲双胍与新出现的疗法的作用，这些新疗法包括钠-葡萄糖协同转运蛋白2（SGLT-2）抑制剂、口服避孕药（OCPs）、肌醇补充剂和生活方式改变，从而使临床医生能够根据每位患者的独特表现提供个性化医疗。本综述探讨了这些干预措施对肥胖和非肥胖PCOS女性在减重、激素平衡、月经规律和代谢结果方面的安全性、有效性和临床结局。
