Recommended therapies for metabolic defects in Polycystic Ovary Syndrome

Abstract

Polycystic ovary syndrome (PCOS) is not just a reproductive condition but has metabolic sequelae. The heterogeneity of the condition is reflected in different emphases in patients on expression of these abnormalities. These conditions include effects on lipids, glucose and insulin metabolism, cardiovascular system and weight control. The metabolic syndrome appears to be more common in PCOS. Treatment of metabolic sequelae can be directed to lifestyle interventions including diet and exercise, insulin-sensitizing drugs and management of hyperlipidaemia. The primary goal of treatment in PCOS is to restore reproductive function while improving metabolic sequelae. This is most readily achieved by reducing insulin resistance through a decrease in weight and abdominal fat. Weight loss and exercise reduce insulin resistance, plasma lipids and blood pressure. In summary, there are a range of diets that may be used in PCOS ranging from high protein to high carbohydrate as well as combinations of glycaemic index (GI) foods. The difference in weight between women from the USA with PCOS and Europe may relate to the extensive use of the Mediterranean-type diet in women from Southern Europe who, while suffering from PCOS, do not appear to get the same metabolic sequelae.