Polycystic Ovary Syndrome PCOS Treatment

Since PCOS has no cure, treatment is usually directed at managing the primary symptoms, especially hirsutism, menstrual irregularities and infertility. The choice of treatment will depend on the type and severity of your symptoms, your age and your plans regarding pregnancy.

If you are not planning to become pregnant, taking an oral contraceptive can control menstrual irregularities. Birth control pills inhibit the production and activity of androgens. Oral contraceptives are not recommended for menopausal women or for women with risk factors for certain heart or blood diseases.

By limiting the secretion of androgens, oral contraceptives can help to control other PCOS symptoms. They often reduce acne, lower the risks of ovarian and endometrial cancer and slow hair growth for women with hirsutism. Anti-androgen drugs—e.g., spironolactone, Aldactone®—are also effective in reducing growth of unwanted hair. To further minimize the effects of hirsutism, many women remove excessive hair by shaving, waxing, using depilatories or electrolysis.

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If you do plan to have children, the treatment of choice is usually a fertility drug called Clomid® (clomiphene citrate). Clomiphene is effective in stimulating the ovaries to release eggs. Studies indicate that 80 percent of women with PCOS ovulate in response to clomiphene. Unfortunately, only 50 percent of these women become pregnant. If clomiphene does not work well for you, your physician may try to induce ovulation with a variety of hormone supplements, including follicle-stimulating hormone (FSH) and gonadotropin-releasing hormone (GnRH) drugs such as Lupron® (leuprolide) and Synarel® (nafarelin).

Once you have explored all of your treatment options, you may consider undergoing surgery to remove a wedge of your ovary. In the past, this procedure was a standard treatment for infertility caused by PCOS. Today surgery is a last-resort treatment choice, since it can cause scar tissue to form in your pelvis, further reducing your chance of becoming pregnant.

To lower health risks such as diabetes and heart disease, your doctor may prescribe an insulin-sensitizing drug to decrease insulin resistance (e.g., Metformin®, Avandia®). These medications have the added benefit of reducing androgen production and restoring normal menstrual cycles.

While medications such as the ones discussed above do have proven benefits, don’t overlook one of the simplest and most effective methods of treating PCOS: weight loss. Obesity aggravates most of the symptoms of PCOS and is an overall health risk all by itself. If you are overweight or obese and you make an effort to lose weight through a program of diet and exercise, you will reduce your insulin resistance, lower the secretion of androgens and lower your estrogen levels. This may help eliminate excessive hair growth, restore regular menstrual periods and improve your chances of becoming pregnant, as well as improving your overall health and wellbeing.

At present, PCOS is treated on a symptom-by-symptom basis by medication, dietary changes and exercise. Researchers are continuing to investigate both the causes of this syndrome and improved treatment options. If you have PCOS, the changes I list below may help you manage your condition so that you can lead a healthier and more satisfying life.

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