Types of Drugs Used to Treat PCOS

There is no cure for polycystic ovary syndrome (PCOS), so the condition is typically treated by managing and improving symptoms. This is often achieved with medications that help mitigate the effects of the disease, like menstrual dysfunction, weight changes, infertility, and insulin resistance.

Read on to learn about the medications used to manage PCOS symptoms.

Menstrual Dysfunction

PCOS is characterized by hormonal abnormalities that can result in infrequent periods (oligomenorrhea) or absent periods (amenorrhea).

Some drug therapies can regulate hormones to restore a normal menstrual cycle.

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

• Birth control pills, which override the menstrual cycle by preventing ovulation
• Provera (medroxyprogesterone), an oral form of the female hormone progesterone that's used to treat secondary amenorrhea

Infertility

For many women, PCOS-related hormonal dysfunction can make it difficult to get pregnant. This is often related to irregular or absent ovulation (anovulation), which means that a woman doesn't release an egg that can be fertilized.

There are medications that can improve the chances of getting pregnant for those experiencing infertility. these treatments are used either alone or in combination.

Medications used for treating infertility n PCOS include:

• Clomid (clomiphene citrate), the most commonly used fertility drug, works better for some women with PCOS than others.
• Femara (letrozole), a medication mainly used to treat breast cancer, has also been shown to stimulate ovulation and it is used off-label for this purpose.
• Glucophage (metformin), a commonly prescribed diabetes drug, may enhance the effectiveness of fertility drugs and improve menstrual regularity. It is not approved for use in people with PCOS without diabetes.
• Gonadotropins, injectable hormones comprised of follicle-stimulating hormone (FSH) and/or luteinizing hormone (LH), are commonly used when Clomid or Femara don't 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.

In experimental studies, 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

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 may include:

• Contrave (naltrexone/bupropion), which curbs food cravings by stimulating both the reward and hunger centers of the brain
• Qsymia (phentermine/topiramate), an appetite suppressant that works similarly to Contrave
• Saxenda (liraglutide), used to treat insulin resistance and obesity
• Wegovy (semaglutide), a once-weekly injection that helps suppress appetite and delay emptying of the stomach
• Xenical (orlistat), a drug that can prevent the absorption of fat

It's important to note that Belviq (lorcaserin), a previously prescribed weight-loss medication, was withdrawn from the market in February 2020 due to concerns regarding an increased occurrence of cancer in those taking the drug.

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:

• Aldactone (spironolactone), a diuretic that exerts potent anti-androgenic effects
• Propecia (finasteride), used off-label to treat hair loss in women with PCOS
• Vaniqa (eflornithine hydrochloride), a topical cream used to block hair growth

A Word From Verywell

To better cope with the 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.