Article # 233. Polycystic Ovary Syndrome (PCOS) - Treatment Overview

What treatments are available for infertility?

Polycystic Ovary Syndrome (PCOS) - Treatment Overview

Polycystic ovary syndrome (PCOS) is a group of health problems caused by out-of-balance hormones. It often involves irregular menstrual periods beginning in puberty or difficulty getting pregnant.

Regular exercise, a healthy diet, not smoking, and weight control are all important parts of treatment for PCOS. Sometimes, also using a medicine to balance hormones is helpful.

There is no cure for PCOS, but controlling it lowers your PCOS risks of infertility, miscarriages, diabetes, heart disease, and uterine cancer.

Initial treatment

The first step in managing polycystic ovary syndrome (PCOS) is getting regular exercise, eating a healthy diet, and not smoking. This is a medical treatment for PCOS, not just a lifestyle choice. Additional treatments depend on your symptoms and whether you are planning a pregnancy.

•If you are overweight, a small amount of weight loss is likely to help balance your hormones and start up your menstrual cycle and ovulation. Use regular exercise and a healthy weight-loss diet as your first big treatment step. This is especially important if you're planning a pregnancy.

•If you smoke, consider quitting. Women who smoke have higher levels of androgens than women who don't smoke. Smoking also increases your risk of heart disease.

•If you are planning a pregnancy and weight loss doesn't improve your fertility, your doctor may suggest a medicine that helps lower insulin. With weight loss, this can improve your chances of ovulation and pregnancy. Fertility drug treatment may also help start ovulation.

•If you are not planning a pregnancy, you can also use hormone therapy to help control your ovary hormones. To correct menstrual cycle problems, birth control hormones keep your endometrial lining from building up for too long. This is what prevents uterine cancer. Hormone therapy can also help with male-type hair growth and acne. Birth control pills, patches, or vaginal rings are prescribed for hormone therapy. 

Androgen-lowering spironolactone (Aldactone) is often used with estrogen-progestin birth control pills. This helps with hair loss, acne, and male-pattern hair growth on the face and body (hirsutism).

Taking hormones does not help with heart, blood pressure, cholesterol, and diabetes risks. This is why exercise and a healthy diet are a key part of your treatment.

How is it treated?

Regular exercise, healthy foods, and weight control are key treatments for PCOS. Medicines to balance hormones may also be used. Getting treatment can reduce unpleasant symptoms and help prevent long-term health problems.

The first step in managing PCOS is to get regular exercise and eat heart-healthy foods. This can help lower blood pressure and cholesterol and reduce the risk of diabetes and heart disease. It can also help you lose weight if you need to.

•Try to fit in moderate activity and/or vigorous activity on a regular basis. Walking is a great exercise that most people can do.

•Eat a heart-healthy diet. In general, this diet has lots of vegetables, fruits, nuts, beans, and whole grains. It also limits foods that are high in saturated fat, such as meats, cheeses, and fried foods. If you have blood sugar problems, try to eat about the same amount of carbohydrate at each meal. A registered dietitian can help you make a meal plan.

•Most women who have PCOS can benefit from losing weight. Even losing 10 lb (4.5 kg) may help get your hormones in balance and regulate your menstrual cycle. PCOS can make it hard to lose weight, so work with your doctor to make a plan that can help you succeed.

•If you smoke, consider quitting. Women who smoke have higher androgen levels that may contribute to PCOS symptoms.1Smoking also increases the risk for heart disease.

A doctor may also prescribe medicines, such as:

•Birth control pills. They can help your periods be regular and can reduce symptoms such as excess facial hair and acne. An androgen-lowering medicine,spironolactone, may be used with birth control pills to help reduce symptoms even more. These medicines are not used if you are trying to get pregnant.

•A diabetes medicine called metformin. It can help restore regular menstrual cycles and fertility.

•Fertility medicines, if you are trying to get pregnant.

It is important to see your doctor for follow-up to make sure treatment is working and to adjust it if needed. You may also need regular tests to check for diabetes,high blood pressure, and other possible problems.

It may take a while for treatments to help with symptoms such as facial hair or acne. In the meantime:

•Over-the-counter or prescription acne medicines may help with skin problems.

•Waxing, tweezing, and shaving are easy ways to get rid of unwanted hair. Electrolysis or laser treatments can permanently remove the hair but are more expensive. Your doctor can also prescribe a skin cream that slows hair growth for as long as you use it regularly.

•It can be hard to deal with having PCOS. If you are feeling sad or depressed, it may help to talk to a counselor or to other women who have PCOS. Ask your doctor about local support groups, or look for an online group. It can make a big difference to know that you are not alone.