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A review of therapeutic options for managing the metabolic aspects of polycystic ovary syndrome

Abdalla, Mohammed Altigani; Deshmukh, Harshal; Atkin, Stephen; Sathyapalan, Thozhukat


Mohammed Altigani Abdalla

Stephen Atkin


Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women of reproductive age. Metabolic sequelae associated with PCOS range from insulin resistance to type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD). Insulin resistance plays a significant role in the pathophysiology of PCOS and it is a reliable marker for cardiometabolic risk. Although insulin sensitising agents such as metformin have been traditionally used for managing metabolic aspects of PCOS, their efficacy is low in terms of weight reduction and cardiovascular risk reduction compared with newer agents such as incretin mimetics and SGLT2 inhibitors. With current pharmaceutical advances, potential therapeutic options have increased, giving patients and clinicians more choices. Incretin mimetics are a promising therapy with a unique metabolic target that could be used widely in the management of PCOS. Likewise, bariatric procedures have become less invasive and result in effective weight loss and the reversal of metabolic morbidities in some patients. Therefore, surgical treatment targeting weight loss becomes increasingly common in the management of obese women with PCOS. Newer emerging therapies, including twincretins, triple GLP-1 agonists, glucagon receptor antagonists and imeglemin, are promising therapeutic options for treating T2DM. Given the similarity of metabolic and pathological features between PCOS and T2DM and the variety of therapeutic options, there is the potential to widen our strategy for treating metabolic disorders in PCOS in parallel with current therapeutic advances. The review was conducted in line with the recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome 2018.


Abdalla, M. A., Deshmukh, H., Atkin, S., & Sathyapalan, T. (2020). A review of therapeutic options for managing the metabolic aspects of polycystic ovary syndrome. Therapeutic Advances in Endocrinology and Metabolism, 11,

Journal Article Type Review
Acceptance Date Jun 8, 2020
Online Publication Date Jul 6, 2020
Publication Date 2020-01
Deposit Date Jul 17, 2020
Publicly Available Date Jul 20, 2020
Journal Therapeutic Advances in Endocrinology and Metabolism
Print ISSN 2042-0188
Electronic ISSN 2042-0196
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Volume 11
Keywords Bariatric surgery; Dietary intervention; GLP-1; Glucagon-like peptide-1; Incretins hormone; Lifestyle modifications; Metabolic comorbidities; Metabolic syndrome; Obesity; Physical activity; Polycystic ovary syndrome (PCOS); SGLT2 inhibitors; Sodium-glucos
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