GLP-1 Receptor Agonists in Preconception Management of Obese Women with Polyendocrine Metabolic Ovarian Syndrome (PMOS): Metabolic and Reproductive Implications

Turan Kaan Karakaya; Sercan Yılmaz

doi:10.70058/cjm.1924573

GLP-1 Receptor Agonists in Preconception Management of Obese Women with Polyendocrine Metabolic Ovarian Syndrome (PMOS): Metabolic and Reproductive Implications

Abstract

Objective: To evaluate the impact of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) on metabolic parameters, hormonal profiles, and reproductive outcomes in the preconception management of women with polyendocrine metabolic ovarian syndrome (PMOS) and obesity.

Methods: A comprehensive literature search was conducted across scientific databases, including PubMed/MEDLINE, Scopus, and Web of Science, focusing on clinical trials, reviews, and guidelines published between January 2022 and April 2026. Studies evaluating the efficacy, safety, tolerability, and economics aspects of GLP-1 RAs used alone or combined with metformin in obese PMOS phenotypes were systematically analyzed.

Results: GLP-1 RAs demonstrate favorable clinical efficacy compared to conventional lifestyle modifications and metformin in reducing body weight and visceral adiposity. By addressing the adipose-androgen crosstalk and mitigating low-grade chronic inflammation, GLP-1 RAs improve insulin sensitivity and reduce compensatory hyperinsulinemia. This metabolic optimization promotes increased hepatic sex hormone-binding globulin (SHBG) synthesis and decreased circulating free testosterone levels, facilitating the restoration of regular menstrual cycles and spontaneous ovulation. Combination therapy of GLP-1 RAs with metformin yields robust synergistic effects, though consideration of higher treatment costs is warranted. Due to limited definitive data on fetal safety during early pregnancy exposure, a strict pre-pregnancy washout period remains mandatory.

Conclusion: GLP-1 RAs offer a promising, multisystemic therapeutic strategy for the preconception management of PMOS with obesity, effectively breaking the cycle of insulin resistance and hyperandrogenemia. While providing profound metabolic and reproductive benefits, strict adherence to preconception discontinuation protocols is essential. Future large-scale randomized controlled trials are required to further clarify optimal dosing, long-term safety, and definitive gestational outcomes.

Keywords

Supporting Institution

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors

Ethical Statement

Ethics committee approval was not required for this review as it does not involve human or animal participants.

Thanks

None

References

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Details

Primary Language

English

Subjects

Clinical Sciences (Other)

Journal Section

Review Article

Authors

Turan Kaan Karakaya ^*
0000-0001-7730-7690
Türkiye

Sercan Yılmaz
0009-0008-2264-9296
Türkiye

Early Pub Date

May 31, 2026

Publication Date

May 31, 2026

Submission Date

April 7, 2026

Acceptance Date

May 24, 2026

Published in Issue

Year 2026 Volume: 3 Number: 2

DOI

https://doi.org/10.70058/cjm.1924573

IZ

https://izlik.org/JA23UY39NE

Cite

RIS / Bibtex

APA

Karakaya, T. K., & Yılmaz, S. (2026). GLP-1 Receptor Agonists in Preconception Management of Obese Women with Polyendocrine Metabolic Ovarian Syndrome (PMOS): Metabolic and Reproductive Implications. Cerasus Journal of Medicine, 3(2), 157-164. https://doi.org/10.70058/cjm.1924573

AMA

1.Karakaya TK, Yılmaz S. GLP-1 Receptor Agonists in Preconception Management of Obese Women with Polyendocrine Metabolic Ovarian Syndrome (PMOS): Metabolic and Reproductive Implications. Cerasus J Med. 2026;3(2):157-164. doi:10.70058/cjm.1924573

Chicago

Karakaya, Turan Kaan, and Sercan Yılmaz. 2026. “GLP-1 Receptor Agonists in Preconception Management of Obese Women With Polyendocrine Metabolic Ovarian Syndrome (PMOS): Metabolic and Reproductive Implications”. Cerasus Journal of Medicine 3 (2): 157-64. https://doi.org/10.70058/cjm.1924573.

EndNote

Karakaya TK, Yılmaz S (May 1, 2026) GLP-1 Receptor Agonists in Preconception Management of Obese Women with Polyendocrine Metabolic Ovarian Syndrome (PMOS): Metabolic and Reproductive Implications. Cerasus Journal of Medicine 3 2 157–164.

IEEE

[1]T. K. Karakaya and S. Yılmaz, “GLP-1 Receptor Agonists in Preconception Management of Obese Women with Polyendocrine Metabolic Ovarian Syndrome (PMOS): Metabolic and Reproductive Implications”, Cerasus J Med, vol. 3, no. 2, pp. 157–164, May 2026, doi: 10.70058/cjm.1924573.

ISNAD

Karakaya, Turan Kaan - Yılmaz, Sercan. “GLP-1 Receptor Agonists in Preconception Management of Obese Women With Polyendocrine Metabolic Ovarian Syndrome (PMOS): Metabolic and Reproductive Implications”. Cerasus Journal of Medicine 3/2 (May 1, 2026): 157-164. https://doi.org/10.70058/cjm.1924573.

JAMA

1.Karakaya TK, Yılmaz S. GLP-1 Receptor Agonists in Preconception Management of Obese Women with Polyendocrine Metabolic Ovarian Syndrome (PMOS): Metabolic and Reproductive Implications. Cerasus J Med. 2026;3:157–164.

MLA

Karakaya, Turan Kaan, and Sercan Yılmaz. “GLP-1 Receptor Agonists in Preconception Management of Obese Women With Polyendocrine Metabolic Ovarian Syndrome (PMOS): Metabolic and Reproductive Implications”. Cerasus Journal of Medicine, vol. 3, no. 2, May 2026, pp. 157-64, doi:10.70058/cjm.1924573.

Vancouver

1.Turan Kaan Karakaya, Sercan Yılmaz. GLP-1 Receptor Agonists in Preconception Management of Obese Women with Polyendocrine Metabolic Ovarian Syndrome (PMOS): Metabolic and Reproductive Implications. Cerasus J Med. 2026 May 1;3(2):157-64. doi:10.70058/cjm.1924573