Pathogenesis of PCOS: From Metabolic and Neuroendocrine Implications to the Choice of the Therapeutic Strategy

PCOS is a quite frequent reproductive disease that affects 5–20% of the female population. Though specific diagnostic criteria have been established, probably they need an update according to the new insights recently ascertained, that is, insulin resistance (IR) and compensatory hyperinsulinemia. In addition, new specific insights have been demonstrated in animal models of PCOS that suggest a clear role of a neuroendocrinological impairment that might occur during prenatal life and/or after birth affecting the regular function of the reproductive axis. All these aspects suggest that PCOS might have a certain grade of epigenetic origins that might be implemented by familial predisposition to specific dismetabolic diseases such as diabetes. We will try to focus on these aspects to give an update on the putative therapeutical possibilities.