Polycystic ovary syndrome treatment generally focuses on management of your individual main concerns, such as infertility, hirsutism, acne or obesity.
As a first step, your doctor may recommend weight loss through a low-calorie diet combined with moderate exercise activities. Even a modest reduction in your weight — for instance, losing 5 percent of your body weight — might improve your condition.
Your doctor may prescribe a medication to:
Sept. 03, 2014
Regulate your menstrual cycle. To regulate your menstrual cycle, your doctor may recommend combination birth control pills — pills that contain both estrogen and progestin. These birth control pills decrease androgen production and give your body a break from the effects of continuous estrogen, lowering your risk of endometrial cancer and correcting abnormal bleeding. As an alternative to birth control pills, you might use a skin patch or vaginal ring that contains a combination of estrogen and progestin. During the time that you take this medication to relieve your symptoms, you won't be able to conceive.
If you're not a good candidate for combination birth control pills, an alternative approach is to take progesterone for 10 to 14 days every one to two months. This type of progesterone therapy regulates your periods and offers protection against endometrial cancer, but it doesn't improve androgen levels and it won't prevent pregnancy. The progestin-only minipill or progestin-containing intrauterine device are better choices if you also wish to avoid pregnancy.
Your doctor also may prescribe metformin (Glucophage, Fortamet, others), an oral medication for type 2 diabetes that improves insulin resistance and lowers insulin levels. This drug may help with ovulation and lead to regular menstrual cycles. Metformin also slows the progression to type 2 diabetes if you already have prediabetes and aids in weight loss if you also follow a diet and an exercise program.
Help you ovulate. If you're trying to become pregnant, you may need a medication to help you ovulate. Clomiphene (Clomid, Serophene) is an oral anti-estrogen medication that you take in the first part of your menstrual cycle. If clomiphene alone isn't effective, your doctor may add metformin to help induce ovulation.
If you don't become pregnant using clomiphene and metformin, your doctor may recommend using gonadotropins — follicle-stimulating hormone (FSH) and luteinizing hormone (LH) medications that are administered by injection. Another medication that your doctor may have you try is letrozole (Femara). Doctors don't know exactly how letrozole works to stimulate the ovaries, but it may help with ovulation when other medications fail.
When taking any type of medication to help you ovulate, it's important that you work with a reproductive specialist and have regular ultrasounds to monitor your progress and avoid problems.
- Reduce excessive hair growth. Your doctor may recommend birth control pills to decrease androgen production, or another medication called spironolactone (Aldactone) that blocks the effects of androgens on the skin. Because spironolactone can cause birth defects, effective contraception is required when using the drug, and it's not recommended if you're pregnant or planning to become pregnant. Eflornithine (Vaniqa) is another medication possibility; the cream slows facial hair growth in women.
- Hoffman BL, et al. Williams Gynecology. 2nd ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://accessmedicine.com/resourceTOC.aspx?resourceID=768. Accessed June 2, 2014.
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- Polycystic ovary syndrome (PCOS) fact sheet. Womenshealth.gov. http://www.womenshealth.gov/publications/our-publications/fact-sheet/polycystic-ovary-syndrome.html. Accessed June 4, 2014.
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