Home > Diseases & Conditions > Pregnancy > Treatment for PCOS:What treatment will I need?
Once you are correctly diagnosed, you can begin any of a number of treatments for PCOS depending on the specific symptoms you are experiencing, your age, and your plans regarding pregnancy. Some treatments can relieve distinct symptoms such as acne and weight gain, for example. Other treatments can help to put your body back into balance with the proper amounts of hormones.
Polycystic ovary syndrome (PCOS) is a group of health problems caused by out-of-balance hormones. It often involves irregular menstrual periods beginning in puberty, or difficulty getting pregnant.
Regular exercise, a healthy diet, not smoking, and weight control are the cornerstone of treatment for PCOS. Sometimes, also using a medicine to balance hormones is helpful.
There is no cure for PCOS, but controlling it lowers your PCOS risks of infertility, miscarriages, diabetes, heart disease, and uterine cancer.
Initial treatment
The first step in managing polycystic ovary syndrome (PCOS) is getting regular exercise, eating a healthy diet, and not smoking. This is a medical treatment for PCOS, not just a lifestyle choice. Additional treatments depend on your symptoms and whether you are planning a pregnancy.
If you are overweight, a small amount of weight loss is likely to help balance your hormones and start up your menstrual cycle and ovulation. Use regular exercise and a healthy weight-loss diet as your first big treatment step. This is especially important if you're planning a pregnancy. If you smoke, consider quitting. Women who smoke have higher levels of androgens than women who don't smoke.1 Smoking also increases your risk of heart disease. If you are planning a pregnancy and weight loss doesn't improve your fertility, your doctor may suggest a medicine that helps lower insulin. With weight loss, this can improve your chances of ovulation and pregnancy. Fertility drug treatment may also help start ovulation.2 If you are not planning a pregnancy, you can also use hormone therapy to help control your ovary hormones. To correct menstrual cycle problems, birth control hormones keep your endometrial lining from building up for too long. This is what prevents uterine cancer. Hormone therapy can also help with male-type hair growth and acne.3Birth control pills, patches, or vaginal rings are prescribed for hormone therapy. Androgen-lowering spironolactone (Aldactone) is often used with estrogen-progestin birth control pills. This helps with hair loss, acne, and male-pattern hair growth on the face and body (hirsutism).3
Taking hormones does not help with heart, blood pressure, cholesterol, and diabetes risks. This is why exercise and a healthy diet are a key part of your treatment.
The following options for treatment for PCOS have helped many women:
Birth control pills, or oral contraceptives, contain female hormones that help to regulate menstrual cycles. Contraceptives also help to lower levels of androgens, reducing abnormal hair growth and improving acne.
Insulin-sensitizing medications used to treat adult-onset diabetes are useful for many women with PCOS. While these medications have not been approved by the U.S. Food and Drug Administration (FDA) specifically for the treatment of PCOS, they seem to improve the regularity of menstrual cycles by lowering insulin levels. Metformin is the most commonly used drug, but doctors should prescribe it with caution. There is not enough research at this time to recommend this drug for all women with PCOS.
Ovulation Induction. In some women who wish to become pregnant, inducing ovulation, which is the release of an egg, is necessary. In current methods of reproductive endocrinology, the initial treatment to induce ovulation is usually an oral medication called clomiphene citrate, which is taken for five days. If clomiphene is not effective, the next order of treatment often includes an injection of gonadotropins. Gonadotropins are hormones that the body produces to stimulate ovulation. Other infertility treatments may include additional medications or laparoscopic surgery. High-tech treatments include in-vitro fertilization, in which an egg fertilized with sperm is implanted in the uterus. The insulin sensitizer metformin appears to be helpful in inducing ovulation and conception in some patients, but it is generally less effective than clomiphene or gonadotropins in inducing pregnancy. Metformin appears to work better in normal weight, rather than obese PCOS patients. At this time there is no consensus on its safety if also used during pregnancy.
Androgen-blocking (anti-androgen) medications can be used to treat several PCOS symptoms, including excess or unwanted hair growth and, to a limited degree, acne and scalp hair loss. Spironolactone, flutamide, finasteride and cyproterone acetate (which is not available in the United States) can help to relieve the symptoms of excessive facial and bodily hair, as well as thinning hair on the scalp and acne. These medications can be taken along with oral contraceptives. Note that although there is extensive worldwide experience with their use in PCOS, none of these medications have been approved for use in the treatment for PCOS by the FDA.
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