Pharmacological modulation of insulin resistance and hyperinsulinemia in polycystic ovary syndrome: The emerging role

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affe cting premenopausal women. Traditional views have emphasized the underlying role of hyperandrogenism and anovulation in this clinical disorder. A grow ing body of evidence, however, recently has emerged to suggest that insulin resistance and hyperinsuline mia assume an early and integral role in the development and natural history of PCOS. Furthermore, pharmacological inter ventions targeted at reducing insulin resistance have proven to produce ben eficial effects in patients with PCOS. In addition, by enhancing insulin se nsitivity through pharmacological modulation, other metabolic derangements commonly associated with insulin resistance and hyperinsulinemia, such as d iabetes, hypertension, dyslipidemia, and coronary artery disease, may be im proved or prevented. An understanding of the emerging role of insulin resis tance and hyperinsulinemia in PCOS will enable appropriate pharmacological strategies to be employed to complement current treatment regimens, thereby facilitating the optimal management of patients with this common and impor tant endocrinopathy.