O uso combinado de análogos do GLP-1 com metformina como alternativa terapêutica para mulheres com síndrome dos ovários policísticos: revisão integrativa

Abstract

Polycystic Ovary Syndrome (PCOS) is a common endocrinopathy, with a prevalence of 6 to 20% among women of reproductive age. It is characterized by hyperandrogenism, irregular menstrual cycles and ovarian structural changes, which can result in infertility, metabolic and endocrinological disorders such as hypercholesterolemia and diabetes. In addition, it can also be associated with an increased risk of depressive disorder and self-image disorders resulting from the consequences of hyperandrogenism. Insulin resistance plays a central role in PCOS, being associated with comorbidities such as obesity, type 2 diabetes and dyslipidemia. Treatment aims to improve symptoms and reduce metabolic risks, with metformin as an important therapeutic pillar to restore insulin sensitivity, improve ovulatory function and potentially increase pregnancy rates. Recent studies have also indicated that GLP-1 analogues (liraglutide and semaglutide) are promising therapeutic options due to their action on glycemic control and modulation of hormone secretion. These drugs, already approved for the treatment of obesity, have shown potential in improving the glycemic profile and regulating the reproductive hormonal axis. The combination of metformin with GLP-1 analogues has shown additional benefits, increasing the chances of ovulation and pregnancy, in addition to promoting weight loss and improving metabolic disorders. This study, based on an integrative review of the literature, highlights that the combination of pharmacological treatments, including metformin and GLP-1 analogues, combined with lifestyle changes, represents an effective approach for the management of PCOS, with a positive impact on fertility and the prevention of long-term metabolic complications. It is concluded that the choice of treatment should be individualized, taking into account the heterogeneity of the condition.