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Table 1 Treatment modalities for Polycystic Ovary Syndrome: mechanism of action and desired clinical impact.

From: State of the Art Review: Emerging Therapies: The Use of Insulin Sensitizers in the Treatment of Adolescents with Polycystic Ovary Syndrome (PCOS)

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
  1. (Adapted from personal communication from Paul Boepple, M.D.)