Treatments for PCOS

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What can you do about PCOS?

You can help yourself managing the symptoms of polycystic ovary syndrome (PCOS) and living a healthier life. Measures such as controlling your weight can help reduce your risk for diabetes, high blood pressure (hypertension), and high cholesterol.

Weight control or weight loss is very important since it can restore normal ovulation cycles and fertility. Weight loss of as little at 5% to 7% over 6 months can reduce male hormone levels and restore ovulation and fertility in more than 75% of women with PCOS.

  • Maintain a healthy body weight. A healthy weight is one at which you feel good about yourself, have energy for work and play, and can manage your PCOS symptoms.
  • Lose weight. Reaching a healthy weight improves your health and prevents long-term complications. Your age, metabolism, genetics, and how much you exercise play an important role in how you gain and lose weight. It’s important that you determine what you alone need to maintain a healthy weight and that you not compare yourself to others.
  • Exercise. Make physical activity a regular and essential part of your day. There are many ways to get exercise; walking is one of the best. Choose fitness activities that are right for you to help boost your motivation. Think about your exercise preferences and try to identify some activities you enjoy.
  • Eat a balanced diet. A balanced, healthy diet, low in Glycemic index and Glycemic load, that includes specific fruits, vegetables, beans and lentils, healthy grains, some dairy products, and healthy fat, supplies your body’s nutritional needs, satisfies your hunger, decreases your cravings, and lowers your risk for other medical conditions, such as diabetes, hypertension, heart disease, cancer, celiac disease, and osteoporosis. Our own diet, The Infertility DietTM, was published as an App on February 3, 2015 (you can download it in the App Store or through the website www.theinfertilitydiet.com).

Medications

Medication treatment for polycystic ovary syndrome (PCOS) focuses on regulating ovulation or treating your insulin resistance or both. Medication treatment for PCOS depends on your symptoms especially if you want to become pregnant. Medication may be prescribed to treat symptoms such as excess hair growth or acne.

Medications to treat reproductive or metabolic problems of PCOS may include:

  • Combination estrogen and progestin hormones, such as birth control pills, vaginal ring, or skin patch. Estrogen may also help reduce your male hormone levels, which would then reduce your acne problems and excess hair growth.
  • Clomiphene citrate (Clomid, Serophene) (fertility medications) and gonadotropin injections (LH and FSH).
  • Insulin sensitizers such as Metformin (Glucophage), Actoplusmet, and Actos. These medications can reduce metabolic problems and male hormone levels in PCOS and thus help restore regular menstrual cycles. The effectiveness of these medication may be increased by any weight loss that occurs at the same time.
  • Medications to suppress male hormones (antiandrogens), such as spironolactone (Aldactone).
  • Synthetic progestin, such as medroxyprogesterone acetate, norethindrone, or progesterone.

Medications to treat excess hair growth (hirsutism), such as spironolactone (Aldactone), may be recommended. This would be an unlabeled use of spironolactone.

Some medications to treat hirsutism may increase your risk for metabolic problems, so it is important to discuss medication side effects with your health professional.

Vaniqa is a skin cream (topical) that reduces hair growth. It is helpful for many women with PCOS, but hair growth returns if the medication is stopped.

Treatment for acne may include nonprescription or prescription skin (topical) or oral medications. Some women notice an improvement in their acne after using combination hormone pills.

Surgery

  • Laparoscopic ovarian drilling is a surgical treatment that can trigger ovulation in women with polycystic ovary syndrome (PCOS) who have not responded to weight loss and fertility medication is now rarely, if ever, indicated. Electrocautery or a laser is used to destroy portions of the ovaries. This surgery is rarely indicated currently because of the effectiveness of medical treatment, and the potential scar tissue formation.