From the Guidelines
Polycystic Ovary Syndrome (PCOS) is characterized by irregular or missed periods, excess androgen levels causing hirsutism and acne, and polycystic ovaries visible on ultrasound, with symptoms including irregular menstrual cycles, excessive facial and body hair, acne, weight gain, thinning scalp hair, and difficulty conceiving. The treatment of PCOS typically involves lifestyle modifications, such as weight loss through diet and exercise, which can improve symptoms and fertility 1. Some key points to consider in the management of PCOS include:
- Lifestyle modifications, including diet and exercise, are first-line treatments for PCOS 1
- Medications, such as combined hormonal contraceptives, metformin, anti-androgens, and ovulation inducers, may be used to address specific symptoms and concerns 1
- Bariatric surgery may be considered for women with PCOS and clinically severe obesity, as it has been shown to improve anthropometric, reproductive, hormonal, and metabolic outcomes 1
- Regular monitoring with a healthcare provider is essential to adjust treatments as needed and screen for associated conditions like diabetes and cardiovascular disease 1 It's worth noting that the diagnosis of PCOS can be challenging, and the detection of biochemical hyperandrogenism is a critical component of the diagnostic workup 1. The most effective treatment approach for PCOS is often a combination of lifestyle modifications and medications, tailored to the individual's specific needs and concerns, with the goal of improving symptoms, fertility, and overall quality of life 1.
From the Research
Symptoms of PCOS
- Irregular or absent menstrual cycles 2, 3, 4
- Issues related to hyperandrogenism, such as acne and hirsutism 2, 5, 4
- Infertility 2, 5, 4
- Polycystic ovaries identified on ultrasonography 2
- Menstrual irregularities due to anovulation or severe oligoovulation 3
- Hyperandrogenism, hyperinsulinaemia and obesity 6
Treatment Options for PCOS
- Lifestyle changes to achieve weight loss 2, 6
- Combination oral contraceptives (COCs) for endometrial protection and to manage acne and hirsutism 2, 5
- Medical or surgical management of obesity 2
- Routine acne treatments 2
- Topical cosmetic treatments, spironolactone, or finasteride for hirsutism 2
- Letrozole as the first-line treatment for PCOS-related anovulation 2
- Gonadotropin-releasing hormone analogues to induce ovulation 2
- Metformin to improve ovulation rates and insulin sensitivity 3, 6
- Flutamide, an antiandrogen drug, to decrease visceral fat, androstenedione, and improve hirsutism 6
- Laparoscopic ovarian drilling or medications such as aromatase inhibitors, glucocorticoids, clomiphene citrate, tamoxifen, or gonadotropins for surgical or medical treatment of PCOS 4