Polycystic Ovary Syndrome in modern medicine: From etiology to diagnosis and evidence-based management

Background Polycystic ovary syndrome is one of the most common endocrine disorders in women of reproductive age and is associated with reproductive dysfunction, metabolic disturbances, and significant psychological burden. The marked heterogeneity of clinical phenotypes and variability in diagnostic criteria complicate timely diagnosis, risk stratification, and long-term management, underscoring the need for an integrated and clinically oriented synthesis of current evidence. Aims The aim of this narrative review is to summarize and integrate contemporary evidence on the epidemiology, pathophysiology, diagnostic approaches, and management of polycystic ovary syndrome, with particular emphasis on the interrelation of reproductive, metabolic, and psychological aspects relevant to clinical practice. Methods A narrative review of the literature was conducted using the PubMed, Google Scholar, and ResearchGate databases. International clinical guidelines, consensus documents, systematic reviews, meta-analyses, randomized controlled trials, cohort and population-based studies, and clinically relevant review articles were considered. The analysis was descriptive in nature and did not involve a formal systematic review protocol or quantitative data synthesis. Results The reviewed evidence confirms that polycystic ovary syndrome should be regarded as a chronic, multisystem condition rather than a disorder limited to reproductive age. Insulin resistance, hormonal dysregulation, and metabolic abnormalities contribute to long term risks, including infertility, type 2 diabetes mellitus, cardiovascular disease, endometrial pathology, and impaired quality of life. Phenotypic heterogeneity and inconsistent application of diagnostic criteria remain major barriers to early diagnosis and individualized management. Lifestyle modification represents the cornerstone of therapy across phenotypes, while pharmacological and fertility directed interventions should be tailored to individual clinical profiles. Psychological comorbidities are common and frequently underrecognized. Conclusions Effective management of polycystic ovary syndrome requires a patient centred and multidisciplinary approach that integrates reproductive, metabolic, and psychological care. Early identification of metabolic risk factors, long term follow up, and systematic attention to mental health are essential to improve clinical outcomes and quality of life.