How is PCOS treated?
We do not yet understand the actual cause for PCOS, and because of this, there is no perfect cure. Instead we try to manage and prevent the varying PCOS problems that occur.
The PCOS treatment goals are based on your PCOS symptoms, also whether or not you want to become pregnant, as well as aimed at lowering your chances of getting heart disease and diabetes in the future. Many women may need a combination of PCOS treatments to meet these goals.
Read below the treatments for PCOS:
- Lifestyle modification: This is weight loss and dietary changes. I recommend downloading my free E-book which discusses this further.
- The oral contraceptive pill: Also called the birth control pill is a PCOS treatment. The pill acts on the ovary by suppressing the ovarian hormones including the male hormones called androgens. By way of altering the ovarian hormones it also regulates the menstrual cycle, and reduces acne, and hirsuitism. While on the “pill” you will not conceive, and once off it your PCOS symptoms will return. But it is a great PCOS treatment to help women who are not wanting to get pregnant.
- Anti-androgen medication: Medicines called anti-androgens may reduce hair growth and clear acne. The tablet Spironolactone (also called Aldactone),has been shown to reduce the impact of male hormones on hair growth in women. The Anti-androgen tablets are often combined with birth control pills. If hirsuitism or acne is your main concern then speak to your doctor about this medication. It is important to note-These medications should not be taken if you are trying to become pregnant.
- The Diabetes medication- Metformin: The medicine called Metformin (also known as Glucophage) has been used to treat type 2 diabetes for many years. It has also been found to help women with PCOS symptoms, though it isn’t approved by the U.S Food and Drug Administration (FDA) for this use. Metformin affects the way insulin controls blood glucose (sugar) and lowers testosterone (androgen hormone) production. It slows the growth of abnormal hair and, after a few months of use, may help ovulation to return. Recent research has shown Metformin to have other positive effects, such as decreased body mass and improved cholesterol levels. I discuss Metformin for PCOS treatment further under the PCOS fertility treatment banner
- Fertility treatment: Lack of or infrequent ovulation is the main cause for fertility problems in women with PCOS. There are varying PCOS fertility treatments, and which type of treatment to use in helping conception will depend on whether there are other issues such as …male factor problems present, the age of the woman…. as this can be significant in relation to the chances of pregnancy. And any other infertility problems present. Several medications that stimulate ovulation can help women with PCOS become pregnant. Even so, other reasons for infertility in both the woman and man should be ruled out before fertility medications are used. Also, be aware that some fertility medications increase the risk for multiple births (twins, triplets).
PCOS Fertility Treatment options include:
- Clomiphene Citrate (Clomid, Serophene) — the first choice therapy to stimulate ovulation for most patients. Metformin taken with clomiphene — may be tried if clomiphene alone fails. The combination may help women with PCOS ovulate on lower doses of medication.
- Gonadotropins (goe-NAD-oh-troe-pins) — given as subcutaneous injections under the skin, but are more expensive and raise the risk of multiple births compared to clomiphene. Go to Ovulation Induction to read further
- Ovulation Induction and Intrauterine insemination. Go to Intrauterine insemination to read further.
- Another option is invitro fertilization (IVF). IVF offers the best chance of becoming pregnant in any given cycle. It also gives better control over the reduced chances of multiple births. But, IVF is very costly.
- Laparoscopic ovarian drilling: Ovarian drilling” is a surgery that may increase the chance of ovulation. It’s sometimes used when a woman does not respond to fertility medicines. It is a day surgery procedure and involves having key hole surgery called a laparoscopy. Here a telescope is put through your belly button into the abdomen (stomach). The doctor then punctures the surface of 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 is thought to lower the male hormone levels (androgens) and help with inducing ovulation. But, these effects may only last up to 6 months.