Polycystic ovary syndrome: modern aspects of pathogenesis, diagnosis, and therapy

Abstract

Background: Polycystic ovary syndrome (PCOS) is among the most prevalent endocrine disorders in women of reproductive age, with a global prevalence ranging from 8% to 13%, depending on diagnostic criteria. It is a multifactorial condition associated with hormonal imbalance, insulin resistance, chronic inflammation, and genetic predisposition. Objective: To summarize current evidence on the pathogenesis, diagnostic approaches, and treatment strategies for PCOS, with an emphasis on personalized medicine and emerging therapeutic directions. Methods: A systematic literature review was conducted in accordance with PRISMA guidelines. Sources included PubMed, Google Scholar, and eLibrary. Inclusion criteria encompassed peer-reviewed studies focused on reproductive endocrinology in women aged 18 to 45 years, using established diagnostic criteria (NIH, Rotterdam, AE-PCOS). Studies of low methodological quality, small sample size, or without full-text availability were excluded. Fifty high-quality publications were selected for final analysis. Results: PCOS is recognized as a systemic disorder necessitating a multidisciplinary and individualized treatment approach. Conventional management includes pharmacological therapies such as combined oral contraceptives, insulin sensitizers, and ovulation induction agents. Lifestyle modifications and assisted reproductive technologies (ART) significantly enhance reproductive outcomes. Emerging evidence suggests a critical role for genetic variants, gut microbiota alterations, and novel biomarkers in advancing diagnostic accuracy and tailoring treatment.