POLYCYSTIC OVARY SYNDROME: DIAGNOSTIC CRITERIA AND TREATMENT METHODS

Abstract

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age, characterized by marked clinical heterogeneity, phenotypic variability, and a high risk of metabolic and reproductive complications. The condition has a multifactorial etiology and a complex pathogenesis, including disturbances in neuroendocrine regulation, insulin resistance, and hyperandrogenism, which result in a wide spectrum of clinical manifestations and complicate timely diagnosis.

The article summarizes current scientific data on the diagnostic criteria and treatment approaches for PCOS in accordance with international guidelines from 2018–2023. The role of the Rotterdam criteria as the basis for diagnosis is highlighted, as well as the особеності of their application across different age groups, particularly in adolescents, taking into account the risks of overdiagnosis and underdiagnosis. Special attention is paid to the role of anti-Müllerian hormone as a potential adjunctive biomarker of polycystic ovarian morphology, as well as to the limitations of its clinical use associated with variability in measurements and the lack of standardized reference values. Key pathogenetic mechanisms of the disease are analyzed, including insulin resistance, hyperandrogenism, dysfunction of the hypothalamic–pituitary–ovarian axis, and their relationship with metabolic changes. Modern therapeutic strategies based on a multidisciplinary and individualized approach are considered, including lifestyle modification, the use of combined oral contraceptives, insulin-sensitizing agents, inositols, and fertility restoration methods, including ovulation induction. The importance of early diagnosis, comprehensive assessment of cardiometabolic risks, long-term monitoring, and personalized management of patients with PCOS is emphasized in order to improve quality of life, preserve reproductive health, and prevent long-term complications.

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