Effects of endocrine disruptive chemicals (EDCs) and therapeutic approaches to the polycystic ovary syndrome (PCOS): A current state-of-the-art

Polycystic ovary syndrome (PCOS) is an endocrine condition affecting women of reproductive age, characterized by hyperandrogenism, ovulatory dysfunction, and some metabolic disturbances. Emerging evidence has been suggesting a link between certain endocrine-disrupting chemicals (EDCs), such as bisphenol A (BPA) and phthalates, and the pathogenesis and/or exacerbation of PCOS. These exogenous compounds interfere with hormonal function, potentially inducing epigenetic modifications and disrupting insulin sensitivity, primarily when exposure occurs during specific periods. This review explores the role of EDCs in the onset and progression of the condition, and it also outlines current therapeutic strategies, including hormonal contraceptives, insulin sensitizers, ovulation induction agents, and anti-androgenic treatments. Novel approaches targeting gut microbiota, cytokine modulation, and antioxidant therapies are discussed, alongside preventive measures to reduce EDC exposure. Thus, this review highlights the need for a personalized, multimodal management of PCOS, integrating pharmacological, lifestyle, and behavioural intervention. Nevertheless, for some of these therapies, it also emphasizes some lack of causality, as well as limited clinical trial data to support their efficacy.