PCOS

PCOS Treatment

Treatment^[15] for PCOS is individualized. However, while the particular approach taken to treating the disorder may vary from person to person, it’s generally aimed at managing a patient’s unique concerns and symptoms, such as infertility, acne, obesity, or excess body hair (hirsutism). Both lifestyle changes and medication can help women with PCOS manage the disorder and its impacts on their overall health.

PCOS medication

The type of medication^[16] used to treat PCOS will vary depending on the signs and symptoms being managed. In order to regulate your menstrual cycle, your healthcare provider may recommend or prescribe:

• Combination birth control: Hormonal birth control pills, patches, or rings that contain estrogen and progestin decrease the body’s androgen production and regulate estrogen levels. Regulating your hormonal balance can help improve abnormal bleeding, excess hair growth, and acne, as well as decrease your risk of endometrial cancer.
• Progestin therapy: This therapy, which involves taking the hormone progestin for 10–14 days every one or two months, helps regulate menstrual periods and protect against endometrial cancer. However, progestin therapy won’t improve excess androgen levels or prevent pregnancy (while combination birth control does). Two particular options for progestin therapy, the progestin-only minipill norethindrone (generic Camila, Ortho Micronor, Errin) or a progestin-containing intrauterine device (IUD), will be used if you would also like to prevent pregnancy.

To help you ovulate as usual, you may be prescribed:

• Letrozole: Traditionally a breast cancer treatment, letrozole (generic Femara) can help stimulate the ovaries. Clinical studies have indicated that letrozole is superior to clomiphene for ovulation induction; however, this indication hasn’t yet been approved by the U.S. Food and Drug Administration (FDA).
• Clomiphene: Clomiphene (generic Clomid) is an oral anti-estrogen medication that’s taken during the first portion of your menstrual cycle.
• Gonadotropins: Gonadotropins are hormone medications administered via injection.

To help reduce excessive hair growth (hirsutism), your provider may recommend:

• Birth control pills: Hormonal birth control pills help decrease androgen production (which can lead to excessive hair growth).
• Anti-androgen medications: These medications^[17] block the effect of androgens, helping to reduce scalp hair loss, excess facial and body hair growth, and acne. It’s important to keep in mind, however, that these medications are not approved by the Food and Drug Administration (FDA) to treat the symptoms of PCOS, and they may cause problems during pregnancy.

Often used to treat high blood pressure, spironolactone (generic Aldactone) is an anti-androgen medication that blocks the effects on androgen on the skin. Because spironolactone can cause birth defects, those taking it are also required to use effective contraception.

• Eflornithine: Eflornithine (generic Vaniqa) cream can help slow the growth of facial hair in women.

While it’s not a medication, electrolysis is a procedure that can also help remove excess body and facial hair. During this procedure, a tiny needle is inserted into each hair follicle and emits electric currents, damaging—and eventually destroying—the follicle. Your provider may prescribe the following medications for PCOS:

Lifestyle changes and PCOS diet

Because of the health conditions often associated with PCOS, your healthcare provider may recommend^[18] that you start a low-calorie diet and maintain moderate physical activity. Losing even as little a 5% of your body weight may help improve the signs and symptoms of your condition. Losing weight may also help with infertility and increase the effectiveness of your PCOS medications. To help improve the signs and symptoms of PCOS, it’s recommended to:

• Maintain a healthy weight: Losing weight can help lower androgen and insulin levels and may restore ovulation. It may be helpful to meet with a specialist, such as a dietician, to achieve your weight-loss goals.
• Get physical activity: In addition to lowering blood sugar levels, if you have PCOS, increasing your daily physical activity may help treat (or even prevent) insulin resistance. Exercise will also help manage your weight and avoid developing conditions like diabetes.
• Limit your carbohydrates: Eating a diet that’s low in fat and high in carbohydrates may increase insulin levels. If you have PCOS, limiting your carbohydrates and choosing complex carbohydrates (which raises your blood glucose levels more slowly than simple carbohydrates) may help manage your signs and symptoms and help prevent you from developing complications.