Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age, with up to 70% of cases remaining undiagnosed as a result of significant clinical heterogeneity. This review describes in detail the diagnostic criteria for PCOS, analyzes the existing phenotypes of the disease, and also describes the etiopathogenetic significance of insulin resistance (IR) in the development of hyperandrogenism and reproductive disorders. For the choice of treatment tactics, the importance not only of accurate diagnosis of PCOS, but also of determining the clinical phenotype of the disease with a detailed analysis of the morphological structure of the ovaries and an additional study of metabolic parameters, such as body weight and IR index, is emphasized. A differentiated approach to the prescription of insulin sensitizers for various PCOS phenotypes has been substantiated.

Keywords: metabolic hyperandrogenism, polycystic ovary syndrome phenotypes, D-chiro-inositol, myo-inositol, hyperandrogenism, insulin resistance