Treatment of PCOS (Polycystic Ovary Syndrome) isn't a one size fits all approach, and there isn't one therapy that is considered to be above all others. In fact, many treatment options include a combination of medications and lifestyle changes.


PCOS has a wide range of symptoms, many of which may or not be present in an individual. The most common symptoms include abnormal, painful menstrual periods, excess hair growth, difficulty conceiving and acne. What may be most concerning is the elevated risk of certain diseases such as endometrial cancer.


Our best measure of what the best therapies to use are included in the guidelines set forth by The Endocrine Society.


Oral Contraceptives - The Recommended Treatment PCOS

In most cases, the first line therapy for treatment of PCOS are oral hormonal contraceptives. There are a few contraindications to this therapy including age, smoking and of course if you are planning on becoming pregnant. Birth control pills help to regulate menstrual periods. Very often they reduce menstrual pain, bloating and heavy bleeding. Birth control pills typically improve excess hair growth as well.


There are certain birth control pills that may hold an advantage over others. One option is Yaz (Drospirenone/Ethinyl Estradiol), a combined oral contraceptive pill that has anti-androgenic activity, which is very beneficial for lessening hair growth and acne.


If you are overweight, exercise is recommended. Weight loss can improve both reproductive and metabolic dysfunction and can lessen the risk of diabetes and cardiovascular disease. In fact, weight loss/exercise may be the single most beneficial therapy for those with PCOS as it can lead to the improvement of most PCOS symptoms. Unfortunately, sustained weight loss is typically more difficult to achieve in those with PCOS versus the regular population.


There are other medications used for PCOS as well and they tend to focus on specific symptoms.


Metformin

After birth control pills, metformin is the most commonly used medication to treat PCOS. Normally, it is used to improve insulin resistance in diabetics but has shown to help with overall reproductive function.


Thiazolidinediones

Medications in this class include Actos and Avandia. Like metformin, these drugs are indicated for the treatment of diabetes but have been used for PCOS. They don't appear to be more effective than metformin however and have a worse side effect profile.


Spironolactione

This is used for its anti-androgenic effects and is a good option for those who can't take birth control. It can be very beneficial for reducing unwanted hair growth as well improving oily skin and acne.


Clomiphene

This is very often used for problems with infertility.


Treatment of PCOS is very often based on specific patient symptoms. Therefore, you should speak with your doctor regarding the best therapies for YOU.