Types of Drugs Used to Treat PCOS

Polycystic ovary syndrome (PCOS) is a complex hormonal disorder that can cause a cascade of symptoms, ranging from mood swings and abnormal hair growth to irregular periods and insulin resistance. Because there is no cure for PCOS, the condition is treated symptomatically with medications that help mitigate the ill effects of a disease that affects around 5% to 10% of women of childbearing age.

Menstrual Dysfunction

PCOS is characterized by hormonal abnormalities that can result in infrequent periods (oligomenorrhea) or absent periods (amenorrhea). These and other hormonal irregularities can undermine a woman's ability to get pregnant. Drug therapies are aimed at regulating hormones to better restore a normal menstrual cycle.

There are two types of oral medications commonly used to treat menstrual irregularities in women with PCOS:

In addition to these oral medications, vaginal contraceptive rings and intrauterine devices (IUDs) containing progesterone can also help treat menstrual irregularities.

Infertility

PCOS-related hormonal dysfunction can also cause irregular or absent ovulation (anovulation), making it difficult for many women with PCOS to conceive. There are medications that can improve ovulation in those experiencing infertility, used either alone or in combination. These include:

  • Clomid (clomiphene citrate), the most commonly used fertility drug that works better in some women with PCOS than others
  • Femara (letrozole)., a medication mainly used to treat breast cancer that has also been shown to stimulate ovulation as well
  • Glucophage (metformin), a commonly prescribed diabetes drug that may enhance the effectiveness of fertility drugs and improve menstrual regularity
  • Gonadotropins, injectable hormones comprised of follicle-stimulating hormone (FSH) and/or luteinizing hormone (LH) that are commonly used when Clomid or Femara fail to induce ovulation

Although Clomid is considered the first-line treatment of female infertility in general, Femara may work better in women with PCOS as it neither raises estrogen levels nor increases the risk of multiple births to the same degree as Clomid.

The non-hormonal supplement inositol has also been shown to improve egg and embryo quality while increasing pregnancy rates in women with PCOS.

Insulin Resistance

Around 50% to 70% of women with PCOS will develop diabetes or prediabetes by the age of 40 due to the onset of insulin resistance (a condition influenced by imbalances in estrogen production). These women are also at greater risk of gestational diabetes, a condition caused by the impairment of glucose metabolism during pregnancy.

Diabetes drugs are commonly used to treat insulin resistance in women with PCOS, the options of which include:

  • Glucophage (metformin), the first-line oral drug of choice that can control diabetes while promoting weight loss
  • Actos (pioglitazone), an oral drug used to reduce high blood sugar
  • Avandia (rosiglitazone), an oral drug of the same class as pioglitazone
  • Avandamet, a combination of rosiglitazone and metformin
  • Victoza (liraglutide), an injectable drug used to control insulin and glucose levels

In addition to medications, lifestyle modifications (including routine exercise and diets low in fats and refined sugars) are considered central to treatment.

Weight Gain

Roughly half of women with PCOS are overweight or obese. Not only does PCOS contribute to weight gain, but it also makes it far more difficult for women to lose weight. In addition to exercise and diet, drug therapies are sometimes used to assist with weight loss.

Current options include:

Hyperandrogenism

Women with PCOS often have elevated levels of male hormones (androgens), including testosterone. The condition, referred to as hyperandrogenism, can lead to lead to the onset of secondary male characteristics in such as male-pattern hair loss and hirsutism (excessive facial and body hair growth).

Hyperandrogenism is commonly treated with drugs that either block androgen production or counteract the effects of abnormal hair growth. These include:

In addition to changes in hair growth, hyperandrogenism can lead to the development of acne. PCOS-induced acne is typically treated with topical preparations such as benzoyl peroxide, salicylic acidretinoids, or antibiotics.

A Word From Verywell

To better cope with the plethora of symptoms that PCOS can cause, you may need to work with one or more doctors experienced with the disorder. This may include a gynecologist, an endocrinologist, or a fertility specialist known as a reproductive endocrinologist.

Because the treatment of PCOS can affect other hormone-influenced conditions, including high blood pressure and diabetes, it is important that these specialists work in coordination with your primary care physician or any other specialist you may be seeing.

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