Diagnosis and Management of Insulin Resistant Polycystic Ovarian Syndrome: A Simplified Review

Pharmaceutical Science-Pharmacology for Better Drug Discovery

Abstract

Polycystic Ovarian Syndrome abbreviated as PCOS is one of the common leading endocrine syndromes in middle aged  women.  PCOS  itself  is  a  collection  of  metabolic  risks  and  symptoms  such  as  hyperandrogenism,  infertility, hyperinsulinemia, dyslipidemia, ovulatory dysfunction, type 2 diabetes and endometrial cancer and increased blood pressure Some of these metabolic risks are the physiological drivers of the syndrome and one such risk is insulin resistance. Around 50-70%  of  the  women  diagnosed  with  PCOS  are  showing  the  symptoms  of  insulin  resistance.  Despite  obesity,  insulin resistance  is seen in both lean and obese PCOS patients. But obesity may be part of the reason for insulin resistance  in women with PCOS. Hence hyperandrogenism is more favoured in women with obesity. Although IR associated with PCOS is a common feature, dysregulation  of the insulin activity is related to the pathogenesis of PCOS. This chronic condition will escort the syndrome to major metabolic disorders substantially increasing the risk for developing diabetes (prediabetes or type2 diabetes) and furthermore increased hyperandrogenism. Various tests have been developed to determine the insulin resistance like HOMA-IR, clamp techniques, glucose and insulin levels. In addition, till to date diverse advanced markers have been proposed in the scientific literature to diagnose insulin resistance, PCOS and their association. Further research into the basic fundamentals of the syndrome is necessary to manage the disorder. The purpose of this review article is to deliver the  simplified  view  on  insulin  resistance  PCOS  for  the  better  understanding  of  the  etiology,  symptoms,  diagnosis  and therapeutic management.