From the Guidelines
The standard treatment for Polycystic Ovary Syndrome (PCOS) focuses on managing symptoms and addressing underlying hormonal imbalances through lifestyle modifications and medications, with first-line treatment including weight loss through diet and exercise for overweight patients, as even a 5-10% reduction in body weight can significantly improve symptoms 1.
Key Components of PCOS Treatment
- Lifestyle modifications: weight loss, diet, and exercise to improve insulin sensitivity and reduce androgen levels
- Hormonal contraceptives: combined oral contraceptives like Yasmin, Diane-35, or Yaz to regulate menstrual cycles, reduce androgen levels, and improve acne and hirsutism
- Metformin: 500-2000mg daily to improve insulin sensitivity, particularly in patients with insulin resistance or prediabetes
- Anti-androgen medications: spironolactone (50-200mg daily) may be added after 6 months if hormonal contraceptives alone are insufficient for hirsutism
- Ovulation induction: clomiphene citrate (50-150mg on cycle days 3-7) or letrozole (2.5-7.5mg on cycle days 3-7) for women seeking pregnancy
Importance of Individualized Treatment
Treatment should be individualized based on the patient's specific symptoms, reproductive goals, and metabolic profile, with regular monitoring essential to evaluate treatment effectiveness and adjust as needed 1.
Role of Lifestyle Modifications
Lifestyle modifications, including weight loss and exercise, are fundamental in managing PCOS symptoms, with evidence showing that multicomponent lifestyle intervention can improve reproductive, metabolic, and anthropometric factors 1.
Medications for PCOS
Medications such as metformin, hormonal contraceptives, and anti-androgen medications play a crucial role in managing PCOS symptoms, with the choice of medication depending on the patient's specific needs and symptoms 1.
From the FDA Drug Label
Clomiphene citrate is indicated for the treatment of ovulatory dysfunction in women desiring pregnancy. Impediments to achieving pregnancy must be excluded or adequately treated before beginning clomiphene citrate therapy Those patients most likely to achieve success with clomiphene therapy include patients with polycystic ovary syndrome
- The standard treatment for Polycystic Ovary Syndrome (PCOS) may include clomiphene citrate for ovulatory dysfunction in women desiring pregnancy.
- Clomiphene citrate is indicated in patients with PCOS who meet certain conditions, including no pregnancy, no ovarian cysts (except those with PCOS), and normal liver function 2.
- Properly timed coitus in relationship to ovulation is important, and a basal body temperature graph or other tests may help determine if ovulation occurred.
From the Research
Standard Treatment for Polycystic Ovary Syndrome (PCOS)
The standard treatment for PCOS is varied and depends on the individual's symptoms and needs. Some of the common treatments include:
- Weight loss, which is considered the primary therapy for PCOS, as a reduction in weight of as little as 5% can restore regular menses and improve response to ovulation-inducing and fertility medications 3
- Metformin, which has been associated with a reduction in features of metabolic syndrome in premenopausal PCOS women 3
- Clomiphene citrate, which is often used as a first-line pharmacological therapy to improve fertility outcomes 4
- Letrozole, which has been shown to improve live birth rates and clinical pregnancy rates compared to clomiphene citrate 5
Non-Pharmacological Approaches
Non-pharmacological approaches, such as lifestyle changes, are also important in the management of PCOS. These include:
- Diet and exercise, which can help with weight loss and improve insulin sensitivity
- Stress management, which can help with hormonal balance and overall well-being
Pharmacological Approaches
Pharmacological approaches, such as medication, are also used to treat PCOS. These include:
- Oral contraceptives, which can help regulate menstrual cycles and improve hyperandrogenism 6
- Anti-androgen medications, which can help with hirsutism and acne
- Fertility medications, such as gonadotropins, which can help induce ovulation
Individualized Treatment
It's essential to note that each woman with PCOS is unique, and treatment should be individualized based on her specific needs and symptoms. Factors such as age, weight, and hormonal balance should be taken into account when determining the best course of treatment 7, 5.