Emerging Concepts in the Pathogenesis and Treatment of Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is a multifactorial disorder that becomes apparent during adolescence with a variety of hormonal and metabolic symptoms. Patients with PCOS can present with ovulatory dysfunction, polycystic ovaries, androgen excess, metabolic abnormalities or a combination of some or all of these problems. The cause of PCOS is unknown but studies suggest a strong genetic component that is affected by the gestational environment and lifestyle factors. Recent advances in our understanding of genetics, diet-induced inflammation, gut microbiome, epigenetics and molecular toxicology suggest that there may be multiple mechanisms that could contribute to the variety of clinical presentations observed in PCOS. Prepubertal metabolic dysfunction may be one of the first phenotypic traits observed in adolescent girls likely to develop PCOS. In the future it may be possible to identify girls at risk of developing PCOS and implement preventative measures prior to the onset of clinical signs and symptoms. PCOS can be effectively treated with a combination of lifestyle approaches including diet and exercise. There is emerging evidence that a high quality low glycaemic load (GL) diet may have an important role in improving anthropomorphic and metabolic outcomes in women with PCOS.