Polycystic ovary syndrome (PCOS) is the commonest endocrine disorder in women of reproductive age.
Obesity is frequently present in these patients and plays a key role in the pathogenesis of both the endocrine and metabolic abnormalities of the syndrome, particularly
infertility,
hyperandrogenism and
insulin resistance (IR). Diet and exercise is the mainstay of management of
obesity in patients with PCOS. In contrast, the eff ects of
antiobesity agents on weight and on the obesityrelated characteristics of the syndrome remain unclear. The aim of the present review is to summarize the current data on the eff ects of
antiobesity drugs approved in Europe (
orlistat,
liraglutide 3 mg od and
naltrexone/
bupropion) on
weight loss in patients with PCOS and to discuss their impact on the endocrine, reproductive and metabolic abnormalities of this population. Several studies reported that
orlistat induces
weight loss, improves IR and reduces
androgen levels in PCOS. In contrast, data regarding the eff ects of the dose of
liraglutide that is approved for the treatment of
obesity (3 mg od) are very limited.
Liraglutide 1.2-1.8 mg od results in
weight loss in these patients but does not aff ect IR or
androgen levels. Finally, there are no studies that evaluated
naltrexone/
bupropion in patients with PCOS and early studies reported conflicting results regarding the eff ects of
naltrexone monotherapy on weight, IR and
androgen levels. In conclusion,
orlistat appears to have a role in the management of
overweight and obese patients with PCOS whereas more studies are needed to clarify the role of
liraglutide and
naltrexone/
bupropion.