Polycystic Ovary Syndrome (PCOS) Treatments & Care

When it comes to treatments for polycystic ovary syndrome (PCOS), managing symptoms helps you restore reproductive balance and live a healthier life. Lifestyle modifications such as controlling your weight significantly reduce long-term risks for Type 2 diabetes, high blood pressure (hypertension), and high cholesterol.

Weight control or weight loss is critically important because it directly restores normal ovulatory cycles and natural fertility. Modest weight loss of as little as 5% to 7% over a 6-month period reduces circulating male hormone (androgen) levels and restores spontaneous ovulation and fertility in more than 75% of women with PCOS.

• Maintain a Healthy Weight: A weight where you feel energized, confident, and able to manage metabolic symptoms.
• Individualized Approach: Age, metabolism, genetics, and activity levels dictate how you gain and lose weight. Tailor your plan to your unique body without comparing yourself to others.
• Regular Exercise: Make physical activity a daily routine—brisk walking is one of the most effective, accessible forms of exercise to improve insulin sensitivity.

A balanced, healthy diet low in Glycemic Index (GI) and Glycemic Load (GL) supplies your body's nutritional needs while satisfying hunger and eliminating carbohydrate cravings. Emphasizing specific vegetables, fruits, lentils, beans, healthy grains, and healthy fats lowers long-term risks for diabetes, heart disease, hypertension, and osteoporosis.

Dr. Fady Sharara published The Infertility Diet™ as a dedicated mobile application on February 3, 2015. Patients can download the App or learn more at www.theinfertilitydiet.com.

Medical management of PCOS focuses on regulating ovulation, improving insulin resistance, or both, depending on whether active pregnancy is desired:

• Ovulation Induction Fertility Medications: Letrozole, Clomiphene citrate (Clomid, Serophene), and injectable gonadotropins (LH and FSH) to stimulate mature egg development.
• Insulin Sensitizers: Metformin (Glucophage), Actoplusmet, and Actos lower metabolic risks, reduce male hormone levels, and help restore regular menstrual cycles. Effectiveness is enhanced when paired with weight loss.
• Combination Estrogen & Progestin Hormones: Birth control pills, skin patches, or vaginal rings to regulate periods and suppress excess androgen production (reducing acne and hirsutism).
• Antiandrogens & Progestins: Spironolactone (Aldactone) to suppress male hormones and reduce excess hair growth; synthetic progestins (medroxyprogesterone, progesterone) to protect the endometrial lining.
• Topical Hair & Acne Treatments: Vaniqa skin cream to slow unwanted facial hair growth, alongside specialized dermatological therapies.

In the past, laparoscopic ovarian drilling (using electrocautery or laser to puncture portions of the ovaries) was performed to trigger ovulation in women unresponsive to oral fertility drugs.

Today, laparoscopic ovarian drilling is rarely, if ever, indicated. The high efficacy of modern medical treatments (such as Letrozole and Metformin) and the potential risk of pelvic scar tissue formation mean that surgical intervention for PCOS has been almost entirely replaced by safe, highly effective medical protocols.