Polycystic Ovary (cont.)

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What treatments are available for PCOS?

Treatment of PCOS depends partially on the woman's stage of life. For younger women who desire birth control, the birth control pill, especially those with low androgenic (male hormone-like) side effects can cause regular periods and prevent the risk of uterine cancer. Another option is intermittent therapy with the hormone progesterone. Progesterone therapy will induce menstrual periods and reduce the risk of uterine cancer, but will not provide contraceptive protection.

For acne or excess hair growth, a water pill (diuretic) called spironolactone (Aldactone) may be prescribed to help reverse these problems. The use of spironolactone requires occasional monitoring of blood tests because of its potential effect on the blood potassium levels and kidney function. Eflornithine (Vaniqa) is a cream medication that can be used to slow facial hair growth in women.Electrolysis and over-the-counter depilatory creams are other options for controlling excess hair growth.

For women who desire pregnancy, a medication called clomiphene (Clomid) can be used to induce ovulation (cause egg production). In addition, weight loss can normalize menstrual cycles and often increases the possibility of pregnancy in women with PCOS. Other, more aggressive, treatments for infertility (including injection of gonadotropin hormones and assisted reproductive technologies) may also be required in women who desire pregnancy and do not become pregnant on Clomid therapy.

Metformin(Glucophage) is a medication used to treat type 2 diabetes. This drug affects the action of insulin and is useful in reducing a number of the symptoms and complications of PCOS. Metformin has been shown to be useful in the management of irregular periods, ovulation induction, weight loss, prevention of type 2 diabetes, and prevention of gestational diabetes mellitus in women with PCOS.

Obesity that occurs with PCOS needs to be treated because it can cause numerous additional medical problems. The management of obesity in PCOS is similar to the management of obesity in general. Weight loss can help reduce or prevent many of the complications associated with PCOS, including type 2 diabetes and heart disease. Consultation with a dietician on a frequent basis is helpful until just the right individualized program is established for each woman.

Finally, a surgical procedure known as ovarian drilling can help induce ovulation in some women who have not responded to other treatments for PCOS. In this procedure a small portion of ovarian tissue is destroyed by an electric current delivered through a needle inserted into the ovary.

Medically reviewed by Mikio Nihira, MD; American Board of Obstetrics and Gynecology
REFERENCES:

American Association of Clinical Endocrinologists Polycystic Ovary Syndrome Writing Committee; American Association of Clinical Endocrinologists Position Statement on Metabolic and Cardiovascular Consequences of Polycystic Ovary Syndrome. Endocr Pract. 2005 Mar-Apr;11(2):126-34. No abstract available.

Azziz R; Sanchez LA; Knochenhauer ES; Moran C; Lazenby J; Stephens KC; Taylor K; Boots LR. Androgen excess in women: experience with over 1000 consecutive patients. J Clin Endocrinol Metab 2004 Feb;89(2):453-62.

Azziz R; Woods KS; Reyna R; Key TJ; Knochenhauer ES; Yildiz BO. The prevalence and features of the polycystic ovary syndrome in an unselected population. J Clin Endocrinol Metab 2004 Jun;89(6):2745-9. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004 Jan;81(1):19-25.

Schroeder BM; American College of Obstetricians and Gynecologists. ACOG releases guidelines on diagnosis and management of polycystic ovary syndrome. Am Fam Physician. 2003 Apr 1;67(7):1619-20, 1622. No abstract available.

Previous contributing medical author: Carolyn J. Crandall, MD


Medically Reviewed by a Doctor on 12/16/2013

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