PCOS Treatments

Everything You Need to Know

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Lifestyle Modification

Thankfully, a number of PCOS treatments are available today that can help you manage the disease. However, the single most important PCOS treatment is to lose weight if you are overweight. By reducing calories and simple sugars, increasing lean protein and fiber, and beginning a regular exercise routine, you can help your body increase its response to insulin, and possibly decrease androgen production. This may help reduce symptoms, restore normal menses and make it easier to conceive. While there are medications that can help manage the symptoms you are experiencing, losing weight is the best thing you can do to help treat the disease.

Regulating the Menstrual Cycle

For women who are currently not interested in having a baby, oral contraceptives -- also known as “the pill” -- are usually a practitioner’s first choice. The pill contains a combination of estrogen and progesterone which aids in regulating a woman’s hormones. This will help normalize your cycle, thereby making your periods more regular. Even though the lack of periods may seem convenient, sustained lengths of time without a period may increase your risk of endometrial cancer.

Your doctor may feel it necessary to give you a medication called Provera (medroxyprogesterone) which will induce bleeding if you have not had a period in a while. Provera is an oral medication which is taken for 5 to 10 days and will bring on a period. You may need a blood test prior to beginning this medication to confirm that you are not pregnant.

Alternative Treatment

Some studies have been shown to have a slight correlation between acupuncture and the success of fertility therapy. It is thought that it may help regulate the menstrual cycle and even induce ovulation in some women. However, before beginning any therapy, make sure to speak with your doctor and find a qualified practitioner with experience in women’s health issues.


While rarely performed, there is a surgical option to help treat PCOS. Called ovarian drilling, the doctor makes tiny incisions into your abdomen and using a very small camera to assist him in visualizing your internal organs, makes small burns on the enlarged ovarian follicles. The hope is to reduce androgen and LH secretion, thereby inducing ovulatory cycles.

Even less common is Ovarian Wedge Resection. Due to the increased risk of scarring and permanent ovarian damage, if your doctor suggests this procedure, please get a second opinion. It is no longer recommended in the treatment of PCOS.

Infertility Treatment

If you want to try to have a baby, there are many options. The medication that your doctor will probably prescribe first is Clomid, which may help you ovulate. Towards the middle of your cycle, you may be able to use an ovulation predictor kit which can help you time the best days to begin trying. Keep in mind that some women with PCOS have persistently high LH levels (the hormone detected in ovulation kits), making this method of timing inappropriate.

Because of the connection between PCOS and insulin resistance, medications that are normally used to treat diabetes, namely Metformin, may be used to increase insulin sensitivity. By increasing the body’s response to insulin, it is thought that the ovary may not make as many androgens, which increases the likelihood that ovulation will occur. Metformin may also reduce the levels of circulating androgens, even if you are not trying to conceive. This will help regulate your menstrual cycle and reduce the distressing symptoms that you may be experiencing. Some women may need to take both Clomid and Metformin in order to ovulate. Clomid is a medication that is given to stimulate ovulation in women who do not regularly ovulate. Losing weight can also help accomplish this. In some people, moderate weight loss can help restore ovulation and greatly increase your odds of pregnancy.

If these do not work, the next step will most likely be injectable medications known as Gonadotropins. Each month, Follicle Stimulating Hormone (FSH) is secreted by the pituitary which makes an egg follicle grow. Gonadotropins directly increase the amount of FSH circulating in the body, promoting the growth and development of a mature egg. The doctor will most likely monitor your progress through ultrasound and blood tests. Once the doctor feels that you are close to ovulating, s/he may have you take an injection of Human Chorionic Gonadotropin (HCG) which will trigger your ovulation within 36 hours. This will allow you to more precisely time when to have intercourse or have Intrauterine Insemination (IUI). Your doctor will help you identify which choice is better for you.

Finally, your last choice is In Vitro Fertilization (IVF), a complex process where you will undergo a controlled hyperstimulation of your ovaries through injectable medications. This produces many eggs which the doctor will then remove through a surgical procedure. Fertilization takes place outside of the body and in the more controlled environment of the lab. Growing embryos are then transferred back into the body, where they will hopefully implant in the uterus and form a viable pregnancy. There are many treatment protocols within the IVF process and your doctor will choose the best one, based on your medical history, age, and diagnosis. If standard IVF does not work for you, it can be used with donor eggs, donor sperm, or with a surrogate as necessary.

Managing Symptoms

Medications which suppress androgen secretion are one option that your doctor may give you. Oral contraceptives may help, or the doctor may prescribe an antiandrogenic medication, such as Spironolactone (aldactone). Spironolactone inhibits the testosterone secreted by the body, and also competes for hormone receptors in the hair follicles. Receptors are sites on cells which allow hormones or chemical to bind to them, creating a reaction. If another chemical is in the receptor site, androgens cannot bind to them and stimulate the reaction causing hair growth.

Another medicine which works in the same fashion is Flutamide, which is not typically used due to the effect that the medication has on the liver. If you are taking this medication, it is important to follow up with the appropriate blood tests as your doctor orders to help early detection of liver problems.

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