Background: Polycystic ovary syndrome (PCOS) is an endocrine/metabolic condition. Hyperandrogenism and insulin-resistance with compensatory hyperinsulinemia are important features of PCOS. The aim of this paper is to review the rationale of antiandrogens and insulin-sensitizers use in PCOS management.
Evidence acquisition: We include in our research the most relevant scientific literature about the impact of antiandrogens and insulin sensitizers in PCOS between 1976 and 2025.
Evidence synthesis: According to the most recent recommendations, antiandrogens can be a possible therapeutic option to reduce the impact of hyperandrogenism and treat hirsutism in PCOS patients after a period of 6 months of estroprogestins and/or cosmetic therapy without adequate results. Insulin-sensitizers can decrease the levels of insulin in subjects affected by hyperinsulinemia, improving metabolic and hormonal alterations observed in PCOS patients.
Conclusions: Antiandrogens and insulin sensitizers represent fundamental pharmacological therapies for PCOS management.