Women's Health -
Polycystic Ovarian Syndrome -
Therapies
Because there is no cure for PCOS, it needs to be managed to prevent problems. Treatments are based
on the symptoms each patient is having and whether she wants to conceive or needs contraception.
Following are descriptions of treatments used for PCOS.
Birth control pills
For women who don’t want to become pregnant, birth control pills can
regulate menstrual cycles, reduce male hormone levels, and help to clear acne. However, the birth
control pill does not cure PCOS. The menstrual cycle will become abnormal again if the pill is
stopped. Women may also think about taking a pill that only has progesterone, like Provera, to
regulate the menstrual cycle and prevent endometrial problems. But progesterone alone does not help
reduce acne and hair growth.
Diabetes medications
The medicine, Metformin, also called Glucophage, which is used to
treat type 2 diabetes, also helps with PCOS symptoms. Metformin affects the way insulin regulates
glucose and decreases the testosterone production. Abnormal hair growth will slow down and
ovulation may return after a few months of use. These medications will not cause a person to become
diabetic.
Fertility medications
The main fertility problem for women with PCOS is the lack of
ovulation. Even so, her husband’s sperm count should be checked and her tubes checked to make sure
they are open before fertility medications are used. Clomiphene (pills) and Gonadotropins (shots)
can be used to stimulate the ovary to ovulate. PCOS patients are at increased risk for multiple
births when using these medications. In vitro Fertilization (IVF) is sometimes recommended to
control the chance of having triplets or more. Metformin can be taken with fertility medications
and helps to make PCOS women ovulate on lower doses of medication.
Medicine for increased hair growth or extra male hormones
If a woman is not trying to get
pregnant there are some other medicines that may reduce hair growth. Spironolactone is a blood
pressure medicine that has been shown to decrease the male hormone’s effect on hair. Propecia, a
medicine taken by men for hair loss, is another medication that blocks this effect. Both of these
medicines can affect the development of a male fetus and should not be taken if pregnancy is
possible. Other non-medical treatments such as electrolysis or laser hair removal are effective at
getting rid of hair. A woman with PCOS can also take hormonal treatment to keep new hair from
growing.
Surgery
Although it is not recommended as the first course of treatment, surgery called
ovarian drilling is available to induce ovulation. The doctor makes a very small incision above or
below the navel, and inserts a small instrument that acts like a telescope into the abdomen. This
is called laparoscopy. The doctor then punctures the ovary with a small needle carrying an electric
current to destroy a small portion of the ovary. This procedure carries a risk of developing scar
tissue on the ovary. This surgery can lower male hormone levels and help with ovulation. But these
effects may only last a few months. This treatment doesn't help with increased hair growth and loss
of scalp hair.
A healthy weight
Maintaining a healthy weight is another way women can help manage PCOS.
Since obesity is common with PCOS, a healthy diet and physical activity help maintain a healthy
weight, which will help the body lower glucose levels, use insulin more efficiently, and may help
restore a normal period. Even loss of 10% of her body weight can help make a woman's cycle more
regular.
