Table 1 Treatment modalities for Polycystic Ovary Syndrome: mechanism of action and desired clinical impact.
Therapy | Mechanism of Action | Regular menses | ↓ Androgen levels or effects | Improves insulin sensitivity | Contraception | Metabolic Effects |
|---|---|---|---|---|---|---|
Combination E+P pills | Endometrial changes ↓ GnRH frequency, ↓ LH and FSH ↑ SHBG ↓ androgens (↓ free (active) androgen) | √√ | √ |  | √ | May be associated with worsened lipid profile, hypertension, decreased glucose tolerance, and prothrombotic effects |
Androgen blockers | ↓ androgen action |  | √ |  |  | May be associated with improved lipid profile and blood pressure control |
Weight loss ± insulin sensitizers | ↑ insulin sensitivity ↑ SHBG ↓ androgens (↓ free (active) androgen) | √ | √ | √ |  | Associated with improved glucose tolerance, lipid profile, and blood pressure control |