Mini Review, Androl Gynecol Curr Res Vol: 13 Issue: 1

The Role of Hormonal Therapy in Managing Polycystic Ovary Syndrome (PCOS)

Saleh R^*

Department of health and medicine care, Anguilla

*Corresponding Author:

Saleh R
Department of health and medicine care, Anguilla
E-mail: Saleh_r@gmail.com

Received: 07-March-2025, Manuscript No. AGCR-25-168383, Editor assigned: 08-March-2025, PreQC No. AGCR-25-168383 (PQ), Reviewed: 15-March-2025, QC No. AGCR-25-168383, Revised: 22-March-2025, Manuscript No. AGCR-25-168383 (R), Published: 28-March-2025, DOI:10.4172/2325-9620.1000349

Citation: Saleh R (2025) Department of health and medicine care, Anguilla. Androl Gynecol: Curr Res 13:1.

Copyright: © 2025 Saleh R. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.

Introduction

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders affecting women of reproductive age, characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. It is a complex and heterogeneous condition with multifactorial etiology involving genetic, metabolic, and environmental factors. PCOS not only impacts fertility but also predisposes women to metabolic complications such as insulin resistance, type 2 diabetes, and cardiovascular disease. Hormonal therapy remains a cornerstone in managing both reproductive and metabolic manifestations of PCOS. This editorial explores current hormonal treatment strategies, their mechanisms, and emerging trends in PCOS management [1]-5.

Hormonal Imbalances in PCOS: Pathophysiology Overview

PCOS is characterized by a dysregulated hypothalamic-pituitary-ovarian (HPO) axis resulting in increased luteinizing hormone (LH) secretion, relative follicle-stimulating hormone (FSH) deficiency, and elevated androgen production from the ovaries and adrenal glands. Insulin resistance exacerbates hyperandrogenism by stimulating ovarian androgen synthesis and reducing sex hormone-binding globulin (SHBG) levels, increasing free testosterone. These hormonal disturbances contribute to anovulation, menstrual irregularities, and clinical manifestations such as hirsutism and acne.

Hormonal Therapies in PCOS Management

1. Combined Oral Contraceptives (COCs)

COCs remain the first-line hormonal therapy for menstrual regulation and hyperandrogenism management in PCOS patients not seeking pregnancy. By suppressing LH secretion, COCs reduce ovarian androgen production and increase SHBG levels, decreasing free testosterone. Different formulations containing varying estrogenic doses and progestin types allow individualized treatment balancing efficacy and side effects.

2. Anti-Androgens

Agents such as spironolactone, flutamide, and cyproterone acetate target androgen receptors or androgen synthesis, alleviating symptoms like hirsutism and acne. Often used in combination with COCs to prevent pregnancy, anti-androgens require monitoring due to potential side effects like hepatotoxicity and teratogenicity.

3. Gonadotropins and Ovulation Induction Agents

For women with PCOS-related anovulatory infertility, exogenous gonadotropins and selective estrogen receptor modulators (SERMs) such as clomiphene citrate and aromatase inhibitors like letrozole are employed to induce ovulation. Letrozole has gained preference due to higher ovulation and live birth rates with fewer adverse effects.

4. Insulin-Sensitizing Agents

Although not hormonal per se, medications like metformin improve insulin sensitivity and have been shown to restore ovulatory cycles in some PCOS patients. Metformin is often combined with hormonal therapies to address metabolic and reproductive aspects synergistically.

Emerging and Experimental Hormonal Treatments

Research is ongoing into novel hormonal modulators targeting the HPO axis, including kisspeptin analogs and neurokinin B antagonists, which may normalize gonadotropin secretion. Additionally, selective progesterone receptor modulators and new-generation progestins aim to enhance efficacy while minimizing side effects.

Challenges and Considerations

The heterogeneity of PCOS necessitates personalized treatment plans considering patient goals, symptom severity, metabolic risks, and fertility desires. Long-term safety of hormonal therapies and their impact on metabolic health require further investigation. Moreover, lifestyle modification remains fundamental and should accompany hormonal treatment.

Conclusion

Hormonal therapy plays a pivotal role in managing the reproductive and hyperandrogenic manifestations of PCOS. With evolving understanding of PCOS pathophysiology, treatment strategies are becoming increasingly refined and individualized. Future research focusing on novel hormonal agents and integrated approaches promises improved outcomes for women with PCOS, enhancing both reproductive health and quality of life.

References

1. Johnston AP, Naska S, Jones K, Jinno H, Kaplan DR, et al. (2013) Sox2-mediated regulation of adult neural crest precursors and skin repair. Stem Cell Reports 1: 38-45.
2. Novak D, Huser L, Elton JJ, Umansky V, Altevogt P, et al. (2020) SOX2 in development and cancer biology. Semin Cancer Biol 67(Pt 1): 74-82.
3. Kerr JF, Wyllie AH, Currie AR (1972) Apoptosis:  a basic biological phenomenon with wide-ranging implications in tissue kinetics. Br J Cancer 26: 239-257.
4. Kim C, Kim B (2018) Anti-Cancer Natural Products and Their Bioactive Compounds Inducing ER Stress-Mediated Apoptosis:  A Review. Nutrients 10:  1021.
5. Chaudhary S, Islam Z, Mishra V, Rawat S, Ashraf GM, Kolatkar PR (2019) Sox2:  A Regulatory Factor in Tumorigenesis and Metastasis. Curr Protein Pept Sci 20: 495-504.