多内分泌代谢性卵巢综合征（PMOS，前身为PCOS）的抗雄激素治疗：疗效、安全性和以表型为导向的临床决策
Anti-androgen therapy in polyendocrine metabolic ovary syndrome (PMOS, formerly PCOS): efficacy, safety, and phenotype-oriented clinical decision-making.
摘要(中文译文)
多内分泌代谢性卵巢综合征（PMOS，原称多囊卵巢综合征[PCOS]），以下简称PMOS/PCOS，是育龄期女性中最常见的内分泌代谢性疾病。其特征是存在自我延续的恶性循环，其中高雄激素血症（在部分而非所有表型中居核心地位）作为主要驱动因素，加剧生殖功能障碍、代谢紊乱和心理困扰。抗雄激素治疗仍是缓解高雄激素相关临床体征（包括多毛、痤疮和女性型脱发）的重要治疗手段。在本综述中，我们对PMOS/PCOS中的高雄激素血症进行了全面的分子分析，系统评价了关键抗雄激素药物的疗效，包括复方口服避孕药、螺内酯、醋酸环丙孕酮、非那雄胺及新兴疗法，并评估了其在代谢、生殖及一般不良反应方面的安全性特征。我们进一步探讨了整合管理策略，包括药物治疗、生活方式干预、胰岛素增敏剂（如二甲双胍）及新兴综合方法。重点强调了青少年、计划妊娠女性和肥胖个体的特殊考虑。本综述还讨论了当前的争议，包括长期心血管安全性的不确定性、最佳治疗持续时间以及缺乏预测性生物标志物，并概述了未来研究重点。最后，我们提出了一个实用的表型指导框架，用于高雄激素性PMOS/PCOS的分层临床管理。
Abstract
Polyendocrine metabolic ovarian syndrome (PMOS, formerly polycystic ovary syndrome [PCOS]), hereinafter referred to as PMOS/PCOS, is the most prevalent endocrine metabolic disorder among women of reproductive age. It is characterized by a self-perpetuating cycle in which hyperandrogenemia (central in several, but not all, phenotypes) acts as the primary driver, exacerbating reproductive dysfunction, metabolic disturbances, and psychological distress. Anti-androgen therapy remains an important treatment for alleviating hyperandrogenism-related clinical signs, including hirsutism, acne, and female-pattern hair loss. In this review, we provided a comprehensive molecular analysis of hyperandrogenism in PMOS/PCOS, systematically evaluated the efficacy of key anti-androgen agents, including combined oral contraceptives, spironolactone, cyproterone acetate, finasteride, and emerging therapies, and assessed their safety profiles concerning metabolic, reproductive, and general adverse effects. We further examine integrated management strategies combining pharmacotherapy, lifestyle modifications, insulin sensitizers such as metformin, and emerging integrative approaches. Special considerations for adolescents, women planning pregnancy, and individuals with obesity are highlighted. This review also addressed current controversies, including uncertainties regarding long-term cardiovascular safety, optimal treatment duration, and the lack of predictive biomarkers, outlining future research priorities. Finally, we proposed a practical phenotype-guided framework for the stratified clinical management of hyperandrogenic PMOS/PCOS.
如何引用
AMA
Hongfa Peng, Jingjing Jiang, Zhu Wang, Wei Wang. Anti-androgen therapy in polyendocrine metabolic ovary syndrome (PMOS, formerly PCOS): efficacy, safety, and phenotype-oriented clinical decision-making.. Journal of ovarian research. 2026; doi:10.1186/s13048-026-02201-y.
APA
Hongfa Peng, Jingjing Jiang, Zhu Wang, Wei Wang (2026). Anti-androgen therapy in polyendocrine metabolic ovary syndrome (PMOS, formerly PCOS): efficacy, safety, and phenotype-oriented clinical decision-making.. Journal of ovarian research. https://doi.org/10.1186/s13048-026-02201-y
GB/T 7714
Hongfa Peng, Jingjing Jiang, Zhu Wang, Wei Wang. Anti-androgen therapy in polyendocrine metabolic ovary syndrome (PMOS, formerly PCOS): efficacy, safety, and phenotype-oriented clinical decision-making.[J]. Journal of ovarian research, 2026 doi:10.1186/s13048-026-02201-y.
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