Polycystic ovary syndrome therapeutic methods: A systematic review
DOI:
https://doi.org/10.34119/bjhrv6n1-304Keywords:
polycystic ovary syndrome, vitamin D/PCOS, metformin/PCOS, physical exercise/PCOS, treatments/PCOSAbstract
Polycystic ovary syndrome (PCOS) is a complex and heterogeneous endocrine disorder, whose prevalence in women varies from 6 to 10% in the reproductive period. It can lead to health complications, such as menstrual dysfunction, infertility, hirsutism, acne and metabolic syndrome. The biggest difficulties with this syndrome is to recognize its etiopathogenesis and select the best therapy. This study is a systematic review, which carried out an electronic search in the following databases SCIELO, LILACS, PUBMED, selected 34 articles. The purpose of the review is: to understand the therapeutic methods available for treatment, although there is no cure for the syndrome, the aim of the approach is to minimize the clinical signs and improve the quality of life of these women. The first therapy to be used is the change in lifestyle and changes in the diet, in the background medications are applied. Treatment must be individualized according to the complaints of each patient.
References
Hiam D, Patten R, Gibson-Helm M, Moreno-Asso A, Mcilvenna L, Levinger I. et al. The effectiveness of high intensity intermittent training on metabolic, reproductive and mental health in women with polycystic ovary syndrome: study protocol for the iHIT- randomised controlled trial. Trials. Australian., Apr. 2019;20(221). doi: 10.1186/s13063-019-3313-8
Avila MAP, Bruno RV, Barbosa FC, Andrade FC, Silva ACO, Nardi AE. Polycystic ovary syndrome: implications of metabolic dysfunction. Rev. Col. Bras. Cir. Rio de Janeiro, Apr 2014;41(2):106-110. doi:10.1590/S0100-69912014000200006
Spritzer PM., Oppermann K. Ginecologia endócrina: Hiperandrogenismo. In: Passos EP, Ramos JGL, Martins-Costa SH, Magalhães JA, Menke CH, Freitas F, organizators. Rotinas em Ginecologia. 7 ed. Porto Alegre: Artmed; 2017. p. 741-759.
Spritzer PM., Cruz PD, Machry RV. Reprodução: Síndrome dos ovários policísticos. In: Silveiro SP, Satler F. Rotinas em Endocrinologia. 1 ed. Porto Alegre:Artemed; 2015. p. 395-401.
Sousa RML, Chein MBC, Silva DSM, Dutra MB, Navarro PAAS, Figueiredo Neto JA et al. Perfil metabólico em mulheres de diferentes índices de massa corporal com síndrome dos ovários policísticos. Rev. Bras. Ginecol. Obstet. Rio de Janeiro, Sep 2013; 35(9):413-420. doi:10.1590/S0100-72032013000900006
Azevedo GD, Costa EC, Micussi MTABC, Sá JCF. Modificações do estilo de vida na síndrome dos ovários policísticos: papel do exercício físico e importância da abordagem multidisciplinar. Rev. Bras. Ginecol. Obstet. Rio de Janeiro, May 2008; 30(5):261-267. doi:10.1590/S0100-72032008000500009
Kite C, Lahart IM, Afzal I, Broom DR, Randeva H, Kyrou I et al. Exercise, or exercise and diet for the management of polycystic ovary syndrome: a systematic review and meta-analysis. Syst Ver. United Kingdom, Feb 2019; 8(51). doi:10.1186/s13643-019-0962-3
Eftekhar M, Mirhashemi ES, Molaei B, Pourmasumi S. Is there any association between vitamin D levels and polycystic ovary syndrome (PCOS) phenotypes? Arch. Endocrinol. Metab. São Paulo, Feb 2020; 64(1):11-16. doi:10.20945/2359-3997000000177
Facio-Lince Garcia A, Pérez-Palacio MI, Molina-Valencia JL, Martínez-Sánchez LM. Síndrome de ovario poliquístico y complicaciones metabólicas: más allá del exceso de andrógenos. Rev. chil. obstet. ginecol. Santiago, Dec 2015; 80(6):515-519. doi:10.4067/S0717-75262015000600013
Bednarska S, Siejka A. The pathogenesis and treatment of polycystic ovary syndrome: What's new? Adv Clin Exp Med. Poland, Mar-Apr 2017; 26(2):359-367, Mar-Apr 2017. doi: 10.17219/acem/59380
Stepto NK, Patten RK, Tassone EC, Misso ML, Brennan L, Boyle J et al. Exercise Recommendations for Women with Polycystic Ovary Syndrome: is the evidence enough?. Sports Medicine, Jun 2019; 49(8):1143-1157. Springer Science and Business Media LLC. doi:10.1007/s40279-019-01133-6
Lin AW, Kazemi M, Jarrett BY, Brink HV, Hoeger KM, Spandorfer SD et al. Dietary and Physical Activity Behaviors in Women with Polycystic Ovary Syndrome per the New International Evidence-Based Guideline. Nutrients, Nov 2019; 11(2711). doi:10.3390/nu11112711
Tannus S, Burke YZ, Kol S. Treatment strategies for the infertile polycystic ovary syndrome patient. Womens Health: London, Nov 2015; 11(6):901-912. doi:10.2217/whe.15.40
Avila MAP, Borges LP, Paes MS, Bruno RV, Nardi AE, Pessoa ACM et al. Acantose nigricante: inter-relações metabólicas inerentes à síndrome dos ovários policísticos. Rev. Bras. Ginecol. Obstet. Rio de Janeiro, Sep 2014; 36(9):410-415. doi:10.1590/SO100-720320140005078
Scott D, Harrison CL, Hutchison S, Courten B, Strepto NK. Exploring factors related to changes in body composition, insulin sensitivity and aerobic capacity in response to a 12-week exercise intervention in overweight and obese women with and without polycystic ovary syndrome. Plos One, Aug 2017; 12(8). doi:10.1371/journal.pone.0182412
Costello MF, Misso ML, Balen A, Boyle J, Devoto L, Garad RM et al. Evidence summaries and recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome: assessment and treatment of infertility. Human reproduction open, Jan 2019; 2019:1-24.Oxford University Press (OUP). doi:10.1093/hropen/hoy021
Iwata MC, Porquere L, Sorpreso ICE, Baracat EDD, Soares Junior JM. Association of oral contraceptive and metformin did not improve insulin resistance in women with polycystic ovary syndrome. Rev. Assoc. Med. Bras. São Paulo, Jun 2015; 61(3):215-219. doi:10.1590/1806-9282.61.03.215
Li J, Ng EHY, Stener-Victorin E, Hu Z, Shao X, Wang H et al.Acupuncture treatment for insulin sensitivity of women with polycystic ovary syndrome and insulin resistance: a study protocol for a randomized controlled trial. Trials. China, 2017; 18(115). doi:10.1186/s13063-017-1854-2
PCOS Society (India). Consensus Statement on the Use of Oral Contraceptive Pills in Polycystic Ovarian Syndrome Women in India. Journal of human reproductive sciences, Apr-Jun 2018; 11(2):96-118. doi:10.4103/jhrs.JHRS_72_18
Jiang J, Gao S, Zhang Y. Therapeutic effects of dimethyldiguanide combined with clomifene citrate in the treatment of polycystic ovary syndrome. Rev. Assoc. Med. Bras. São Paulo, Sep 2019; 65(9):1144-1150. doi:10.1590/1806-9282.65.9.1144
Balen AH, Morley LC, Misso M, Franks S, Legro RS, Wijeyaratne CN et al. The management of anovulatory infertility in women with polycystic ovary syndrome: an analysis of the evidence to support the development of global WHO guidance. Hum Reprod Update. Nov 2016; 22(6):687-708. doi:10.1093/humupd/dmw025
Genazzani AD. Inositol as putative integrative treatment for PCOS. Reprod Biomed Online. Dec 2016; 33(6):770-780. Elsevier BV. doi:10.1016/j.rbmo.2016.08.024
Unfer V, Nestler JE, Kamenow ZA, Prapas N, Facchinetti F. Effects of Inositol(s) in Women with PCOS: a systematic review of randomized controlled trials. International Journal Of Endocrinology, 2016: 2016:1-12. Hindawi Limited. doi:10.1155/2016/1849162
Motta ELA, Domingues TS, Soares Junior JM. O uso de sensibilizadores de insulina no tratamento de infertilidade em pacientes com síndrome dos ovários policísticos (SOP). Rev. Bras. Ginecol. Obstet. Rio de Janeiro, Mar 2012; 34(3):99-101. doi:10.1590/S0100-72032012000300001
Mascarenhas M, Balen AH. Treatment update for anovulation and subfertility in polycystic ovary syndrome. Current Opinion In Endocrine And Metabolic Research. Jun 2020; 12:53-58. Elsevier BV. doi:10.1016/j.coemr.2020.03.003
Voulgaris N, Papanastasiou L, Piaditis G, Angelousi A, Kaltsas G, Mastorakos G et al. Vitamin D and aspects of female fertility. Hormones. Greece, 2017; 16(1):5-21. doi:10.14310/horm.2002.1715
Krul-Poel YHM, Koenders PP, Steegers-Theunissen RP, Boekel E, Wee MM, Louwers Y et al. Vitamin D and metabolic disturbances in polycystic ovary syndrome (PCOS): A cross-sectional study. PloS one. Dec 2018; 13(12) e0204748. doi: 10.1371/journal.pone.0204748
Davis EM, Peck JD, Hansen KR, Neas BR, Craig LB. Associations between vitamin D levels and polycystic ovary syndrome phenotypes. Minerva endocrinológica. Jun 2019; 44(2):176-184. doi:10.23736/S0391-1977.18.02824-9
Lumme J, Sebert S, Pesonen P, Piltonen T, Jarvelin MR, Herzig KH et al. Vitamin D Levels in Women with Polycystic Ovary Syndrome: A Population-Based Study. Nutrients. Nov 2019; 11(2831). doi:10.3390/nu11112831
Trummer C, Schwetz V, Kollmann M, Wolfler M, Munzker J, Pieber TR et al. Effects of vitamin D supplementation on metabolic and endocrine parameters in PCOS: a randomized-controlled trial. European journal of nutrition, 2019; 58(5):2019-2028. doi:10.1007/s00394-018-1760-8
Moura HHG, Costa DLM, Bagatin E, Sodré CT, Manela-Azulay M. Síndrome do ovário policístico: abordagem dermatológica. An. Bras. Dermatol. Rio de Janeiro, Feb 2011; 86(1):111-119. doi:10.1590/S0365-05962011000100015
Soares Junior JM, Baracat MCP, Maciel GAR, Baracat EC. Polycystic ovary syndrome: controversies and challenges. Rev. Assoc. Med. Bras. São Paulo, Dec 2015; 61(6):485-487. doi:10.1590/1806-9282.61.06.485
Barthelmess EK, Naz RK. Polycystic ovary syndrome: current status and future perspective. Frontiers in bioscience (Elite edition). Morgantown(WV), Jan 2014; 6:104-19. doi:10.2741/e695
Brasil. Ministério da Saúde. Protocolo Clínico e Diretrizes Terapêuticas Portaria SAS/MS nº 1.321, de 25 de novembro de 2013. Síndrome de ovários policísticos e hirsutismo/acne. Brasília. 2013.
