Unraveling PCOS therapies: Pharmacotherapeutic strategies and emerging therapeutic targets

Polycystic ovary syndrome (PCOS) is a common health problem that can affect the reproductive health of women. A typical characteristic of PCOS is infertility, androgen excess, and anovulation. In addition, a disorder also accompanies other pathologies like obesity and hyperinsulinemia, with an increased threat of cardiovascular complications. Current treatment strategies focus on the reduction of PCOS symptoms primarily through pharmacological medications such as metformin, oral contraceptives, and anti-androgenic agents. Since these medications do not encompass all the outcomes of PCOS, there is a critical need for research to identify more effective treatments. Given the rising global prevalence of PCOS and its association with cardiovascular and metabolic risks, there is an urgent need for better therapeutic options with minimal adverse effects. This review integrates the current pharmacotherapies and emerging molecular and cellular targets, offering novel directions for comprehensive PCOS management. Additionally, this review explores various novel targets such as neuropeptides, inflammasome, anti-inflammatory agents, gene therapy/microRNA (miRNA) based therapies, adipokines-based therapies and stem cells-based therapy. Furthermore, we highlight key areas requiring further research to improve PCOS management.