Polycystic ovary syndrome (PCOS) is a common endocrine system disorder among women of reproductive age. PCOS results from hormonal imbalances and affects a woman’s menstrual cycle, fertility, appearance, and general health. It is estimated that 5 to 10 percent of women have PCOS. While there is no cure for PCOS, lifestyle changes and various treatment options can help manage symptoms. This article outlines the major treatment approaches for PCOS.

Causes and Symptoms of PCOS

The exact cause of PCOS is unknown, but it involves higher than normal levels of male hormones called androgens, problems with the hypothalamus and pituitary glands, and heredity. Common symptoms include irregular or missed periods, excess hair growth, acne, weight gain, pelvic pain, and difficulty getting pregnant. PCOS can affect a woman’s physical and mental health.

Lifestyle Changes

Making lifestyle changes is usually the first step in PCOS treatment. Losing just 5 to 10 percent of your body weight through diet and exercise can help reduce symptoms by restoring a normal menstrual cycle and improving fertility. A heart-healthy diet low in refined carbs and high in lean protein, along with regular physical activity can play a big role in PCOS management. Maintaining a healthy lifestyle is also important for preventing long-term complications like diabetes and heart disease associated with the condition.

Birth Control Pills

Oral contraceptives are often prescribed to regulate menstrual cycles and reduce excess androgen levels and related symptoms. The synthetic estrogen and progestin in birth control pills help stabilize hormone levels. Combination pills containing both hormones are preferred over progesterone-only mini pills which don’t address high androgen levels. Side effects are generally mild but may include weight gain, headache, and nausea. Birth control pills do not directly treat the underlying cause or improve fertility long-term.

Metformin Treatment

Metformin is a medication typically used to treat diabetes but is also commonly used off-label for PCOS. It works by reducing insulin resistance, a condition linked to excess androgen production. Metformin helps restore normal menstrual cycles, improves fertility, and can aid weight loss. Common side effects are nausea and diarrhea which usually go away over time. Metformin doesn’t directly address hormonal imbalance but can be helpful as part of an overall PCOS treatment plan.

IUI and Fertility Medications

If lifestyle changes and oral contraceptives fail to induce ovulation, fertility medications may be tried. Clomiphene citrate (Clomid, Serophene) is typically the first line of treatment to induce ovulation. It works by stimulating ovulation through its effects on the hypothalamus and pituitary glands. Side effects include hot flashes, breast tenderness, and bloating. If Clomiphene fails, other injectable fertility medications like letrozole can be prescribed. If medication alone isn’t enough, IUI (intrauterine insemination) provides higher chances of conception by directly depositing sperm into the uterus around ovulation.

Surgery

Laparoscopic surgery also known as ovarian drilling may be considered for women who don’t respond well to other treatments. During this minimally invasive procedure, a small camera and surgical tools are inserted through small incisions to destroy parts of the ovaries. This helps reduce testosterone levels by damaging the excess ovarian tissue causing hormonal imbalance. Ovarian drilling can restore ovulation and improve fertility. Risks involve general anesthesia and potential ovarian damage or loss of function. Success rates range from 30 to 50 percent.

Long-term Management

Once symptoms are managed, lifestyle changes like healthy diet, exercise, and stress management need to be continued long-term to maintain treatment benefits. Oral contraceptives are usually lifelong to regulate menstrual cycles and prevent symptoms from recurring. Other medications like Metformin may also need to be taken indefinitely to keep insulin resistance and excess androgen levels under control. For women who do become pregnant, treatment aims to have healthy pregnancies and babies. Overall, a multi-disciplinary team approach involving dietitians, nurses, gynecologists and fertility specialists provides best results for PCOS management.

Conclusion

While there is no cure for PCOS, various lifestyle and medical treatment options are available to manage its symptoms effectively. Finding the right treatment plan requires trial and error under medical guidance based on individual symptoms, goals, and response to therapies. With proper treatment and lifelong management, women with PCOS can lead healthy and fulfilling lives including attaining fertility and preventing long-term health risks. Further research continues to uncover better ways to treat PCOS and identify its root causes.

*Note:

1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it