Manejo integral del síndrome de ovario poliquístico: revisión sistemática de estrategias terapéuticas farmacológicas
DOI:
https://doi.org/10.61347/ei.v5i1.256Palabras clave:
Agonistas GLP-1, anticonceptivos orales, hiperandrogenismo, letrozol, metformina, resistencia a la insulina, síndrome de ovario poliquísticoResumen
El síndrome de ovario poliquístico (SOP) constituye el trastorno endocrino-metabólico más prevalente en mujeres en edad reproductiva, afectando al 8–13% de la población femenina mundial. Su naturaleza multifactorial involucra alteraciones hormonales, metabólicas y reproductivas que requieren un abordaje terapéutico integral. El presente estudio tuvo como objetivo analizar y sintetizar de manera crítica la evidencia científica disponible sobre las estrategias terapéuticas farmacológicas para el manejo integral del síndrome de ovario poliquístico, evaluando su eficacia y seguridad en relación con los desenlaces metabólicos, hormonales, reproductivos y la calidad de vida de las pacientes. Se realizó una revisión sistemática siguiendo las directrices PRISMA 2020, mediante una búsqueda estructurada en las bases de datos Scopus y Web of Science durante el período comprendido entre mayo de 2021 y octubre de 2025. Se seleccionaron 20 estudios que cumplieron con los criterios de elegibilidad: 5 ensayos clínicos aleatorizados y 15 revisiones sistemáticas y metaanálisis. La metformina demostró eficacia en la reducción del índice HOMA-IR (-0,50; IC 95%: -0,91 a -0,09) y en la mejora de la tasa de ovulación (OR: 3,88; IC 95%: 2,25–6,69). Los agonistas del receptor GLP-1 mostraron reducciones significativas en el peso corporal (-3,44 kg) y en el IMC (-2,05 kg/m²). El letrozol se estableció como terapia de primera línea para la inducción de la ovulación, con tasas de ovulación del 92,75% en protocolos extendidos. Los anticonceptivos orales combinados demostraron eficacia en el tratamiento del hirsutismo, con una reducción ≥50% en la puntuación de Ferriman-Gallwey. La evidencia respalda un abordaje terapéutico individualizado según el fenotipo predominante. La metformina permanece como piedra angular en el manejo de los desenlaces metabólicos, el letrozol para la infertilidad anovulatoria, los anticonceptivos orales combinados para el hiperandrogenismo, y los agonistas del receptor GLP-1 emergen como una alternativa prometedora en pacientes con obesidad asociada al SOP.
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Derechos de autor 2026 Erika Alexandra Jami Tonato, Ariana Mikaela Chariguaman Rea, Alison Micaela Carrillo Gavilanes, Andrés Santiago Cisneros-Barahona
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial 4.0.
