@article{3120303,
    title = "Tailoring treatment for PCOS phenotypes",
    author = "Papadakis, G. and Kandaraki, E.A. and Garidou, A. and Koutsaki, M. and Papalou, O. and Diamanti-Kandarakis, E. and Peppa, M.",
    journal = "Expert Review of Endocrinology and Metabolism",
    year = "2021",
    volume = "16",
    number = "1",
    pages = "9-18",
    publisher = "Taylor and Francis Ltd.",
    doi = "10.1080/17446651.2021.1865152",
    keywords = "antiandrogen;  antidepressant agent;  antiobesity agent;  anxiolytic agent;  aromatase inhibitor;  clomifene citrate;  hydroxymethylglutaryl coenzyme A reductase inhibitor;  inositol;  insulin sensitizing agent;  metformin;  oral contraceptive agent;  resveratrol;  Muellerian inhibiting factor, acupuncture;  aerobic exercise;  alternative medicine;  anovulation;  anxiety disorder;  body weight loss;  comorbidity;  continuous positive airway pressure;  depression;  diet supplementation;  dietary supplement;  dyslipidemia;  eating habit;  female infertility;  herb;  human;  hyperandrogenism;  insulin resistance;  lifestyle modification;  menstrual irregularity;  metabolic phenotype;  nonalcoholic steatohepatitis;  nonhuman;  obesity;  obesity management;  ovary polycystic disease;  pregnancy;  priority journal;  Review;  sexual dysfunction;  sleep disordered breathing;  adult;  anovulation;  female;  hyperandrogenism;  ovary polycystic disease;  phenotype, Adult;  Anovulation;  Anti-Mullerian Hormone;  Female;  Humans;  Hyperandrogenism;  Phenotype;  Polycystic Ovary Syndrome",
    abstract = "Introduction: Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in reproductive-aged women. Hyperandrogenism, polycystic ovaries, chronic anovulation, and metabolic aberrations are its common features. The treatment approach focuses on the main aberrations, which characterize the different phenotypes. Areas covered: Management strategies targeting the metabolic phenotype include lifestyle modifications for weight loss and improvement of dietary habits, as well as medication, such as insulin-sensitizers. The treatment of hyperandrogenic phenotype includes cosmetic procedures and the combined oral contraceptives with or without antiandrogens. The therapeutic approach to reproductive phenotype includes diet and lifestyle modifications, clomiphene citrate, and aromatase inhibitors. Alternative treatments include dietary supplements, herbs, resveratrol, myo-inositol, and acupuncture. Expert opinion: New studies have shown that higher anti-Müllerian hormone levels, gut microbiome composition, and plasma metabolomics are new parameters that are related to the most severe phenotypes. The clinical phenotypes can change over the lifespan with weight gain and can coexist in the same individual. Individualized treatment remains the main approach but grouping the phenotypes and following therapeutic recommendations may prove to be also clinically appropriate. © 2020 Informa UK Limited, trading as Taylor & Francis Group."
}