Gynäkologische Endokrinologie

, Volume 6, Issue 3, pp 185–194 | Cite as

Konsensusgerechte Therapie des PCOS

Die Rolle von Gewichtsreduktion, Metformin und Clomifen
  • A.N. Schüring
  • K. Oelmeier
  • N. Schulte
  • P. Stute
  • L. Kiesel
CME Weiterbildung • Zertifizierte Fortbildung
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Zusammenfassung

Die Therapieoptionen für das polyzystische Ovarsyndrom (PCOS), eine der häufigsten Endokrinopathien der Frau im reproduktiven Alter, werden seit Langem kontrovers diskutiert. Nachdem in Rotterdam 2003 ein Konsensus zur Diagnostik des PCOS verabschiedet worden war, trafen 2007 in Thessaloniki erneut internationale Experten unter der Schirmherrschaft von ASRM und ESHRE zusammen, um Empfehlungen zur evidenzbasierten Therapie der heterogenen Erkrankung zu erarbeiten [36]. Die kürzlich publizierten Empfehlungen finden im deutschen Sprachraum zunehmend Beachtung. Eingehend bezieht der Konsensus Position zu den kontroversen Fragen, die sich aus dem engen pathogenetischen Zusammenhang von Übergewicht, Insulinresistenz und Hyperandrogenämie für die Therapie des PCOS ergeben. Die folgenden zentralen Aussagen werden getroffen: 1. Für adipöse PCOS-Patientinnen ist eine Änderung der Lebensweise das Mittel der Wahl. 2. Clomifen bleibt First-line-Therapie zur Ovulationsinduktion bei PCOS. 3. Der Insulinsensitizer Metformin ist Clomifen unterlegen und nur bei Insulinresistenz indiziert. Die Empfehlungen des Konsensus hinsichtlich des Themenbereiches Übergewicht, Insulinsensitizer und Clomifen beim PCOS werden in dieser Übersicht zusammengefasst und vor dem Hintergrund der aktuellen Studienlage eingeordnet.

Schlüsselbegriffe

Polyzystisches Ovarsyndrom Konsensus Adipositas Insulinsensitizer Clomifen 

Therapy of PCOS according to the Thessaloniki consensus

The role of weight loss, metformin and clomiphene

Abstract

Treatment options remain controversial for polycystic ovary syndrome (PCOS), one of the most common endocrinopathies of women of reproductive age. Following the Rotterdam consensus meeting of 2003, which covered diagnostic aspects of PCOS, international experts met again in Thessaloniki (Greece) in 2007 under the patronage of ASRM and ESHRE to work on recommendations for the evidence-based therapy of this heterogeneous disease [36]. These recently published recommendations are attracting increasing interest in the German-speaking countries. The consensus includes detailed comments concerning the key pathogenetic factors obesity, insulin resistance, and hyperandrogenemia and their practical implications for therapy. The central statements are as follows: 1. Lifestyle changes are mandatory for overweight PCOS patients. 2. Clomiphene remains the first-line option for ovulation induction in PCOS patients. 3. The insulin-sensitizer metformin is less effective than clomiphene, and its use is recommended only in case of insulin resistance. Here, we summarize the consensus recommendations concerning overweight, insulin sensitizers and clomiphene for the treatment of PCOS and discuss them in the context of recent research results.

Keywords

Polycystic ovary syndrome Consensus Obesity Insulin sensitizer Clomiphene 

Notes

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

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Copyright information

© Springer Medizin Verlag 2008

Authors and Affiliations

  • A.N. Schüring
    • 1
  • K. Oelmeier
    • 1
  • N. Schulte
    • 1
  • P. Stute
    • 1
  • L. Kiesel
    • 1
  1. 1.Klinik und Poliklinik für Frauenheilkunde und GeburtshilfeUniversitätsklinikum MünsterMünsterDeutschland

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