POLYCYSTIC OVARY SYNDROME: THERAPEUTIC STRATEGIES AND CURRENT PERSPECTIVES

Abstract

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age, characterized by a complex pathophysiology and heterogeneous manifestations. Currently, there is no cure for PCOS, making symptomatic management and long-term prevention of comorbidities the cornerstones of treatment. This review consolidates the evidence on therapeutic strategies and future perspectives in the management of PCOS. The first-line approach is unequivocally lifestyle modification, including diet and exercise, which has demonstrated efficacy in improving metabolic and reproductive parameters. Pharmacological treatment is individualized, with combined oral contraceptives being the first-line treatment for menstrual cycle regulation and hyperandrogenism control, and metformin as the mainstay therapy for managing insulin resistance. For infertility, letrozole is increasingly considered superior to clomiphene. Furthermore, a growing body of evidence supports the use of nutritional supplements and complementary therapies, particularly inositols, vitamin D, and probiotics, which act on metabolic and inflammatory pathways. Future prospects include the repositioning of drugs, such as GLP-1 receptor agonists, and the development of therapies that target specific molecular pathways. It is concluded that a multifaceted and personalized approach is essential for the effective management of PCOS, integrating lifestyle interventions, targeted pharmacotherapy, and evidence-based complementary therapies.