GLP-1 Receptor Agonists Show Promise for Weight Loss in PMOS; Metformin Improves Metabolic Outcomes

Polyendocrine metabolic ovarian syndrome (PMOS), formerly known as polycystic ovary syndrome (PCOS), is a prevalent endocrine disorder impacting women of reproductive age. It is characterized by hyperandrogenism and ovulatory dysfunction, leading to significant reproductive, metabolic, and psychological challenges throughout life. Current pharmacotherapy often targets individual symptoms, but comprehensive approaches addressing the complex interplay of insulin resistance, inflammation, and obesity are crucial. This review explores non-hormonal therapies to bridge treatment gaps in managing this multifaceted condition.

This study conducted a narrative review focusing on non-hormonal pharmacological treatments for Polyendocrine Metabolic Ovarian Syndrome (PMOS) in adults. The review aimed to synthesize existing evidence regarding therapies directed at individual patient concerns, including agents for metabolic improvement, weight management, and ovulation induction. The authors specifically examined the roles of metformin, anti-obesity agents (with a focus on glucagon-like peptide-1 receptor agonists), and ovulation induction agents like letrozole, evaluating their efficacy and safety profiles based on available literature.

The review highlighted several key non-hormonal therapeutic strategies for PMOS. Metformin was found to be associated with modest reductions in body weight, alongside improvements in various metabolic and anthropometric outcomes. This suggests its continued utility in addressing the insulin resistance and metabolic dysregulation often seen in PMOS patients. For weight management, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) emerged as an attractive option due to their efficacy in promoting weight loss. However, the review noted that specific data on GLP-1 RAs within PMOS populations remain limited, warranting further dedicated research. Furthermore, safety considerations for GLP-1 RAs in the periconceptual setting were identified as an important factor for clinicians. For ovulation induction, the review affirmed that:

Letrozole is the first-line agent of choice, supported by reassuring safety and efficacy data, making it a reliable option for women with PMOS seeking to conceive. Overall, the findings underscore the need for individualized treatment plans that leverage these agents effectively.