From the Guidelines
Treatment for Polycystic Ovary Syndrome (PCOS) involves a multi-faceted approach, with lifestyle modification being the first-line treatment.
Key Components of Treatment
- Lifestyle modification: This includes a healthy diet and regular exercise, with a focus on weight loss and weight gain prevention 1.
- Pharmacotherapy: Medications such as metformin may be used to improve insulin resistance and hormonal imbalance 1.
- Anti-obesity pharmacological agents: Medications such as glucagon-like peptide 1 receptor agonists (GLP-1 RAs), orlistat, phentermine, and topiramate may be considered for weight loss 1.
- Bariatric surgery: This may be considered for individuals with severe obesity and PCOS, as it has been shown to improve reproductive, metabolic, and hormonal outcomes 1.
Important Considerations
- Weight loss: Even a 5% weight loss can improve PCOS features such as menstrual dysfunction and infertility 1.
- Insulin resistance: This is a key component of PCOS pathophysiology, and lifestyle modification and pharmacotherapy can help improve insulin sensitivity 1.
- Individualized approach: Treatment should be tailored to each individual's needs, taking into account their medical history, lifestyle, and personal preferences.
From the Research
Treatment Options for Polycystic Ovary Syndrome (PCOS)
The treatment for PCOS is mainly symptomatic and aimed at reducing clinical signs of hyperandrogenism, improving menstrual cyclicity, and favoring ovulation 2. The main treatment options include:
- Lifestyle modifications, such as diet and exercise, which represent the first line of intervention 2, 3
- Oral contraceptives, which are used to reduce androgen levels and improve menstrual cyclicity 2, 4, 3
- Metformin, which is used to improve insulin sensitivity and reduce androgen levels 2, 5, 4
- Antiandrogens, such as spironolactone and flutamide, which are used to reduce androgen levels and improve hirsutism 5, 4
- Ovulation induction therapies, such as clomiphene citrate and gonadotropin therapy, which are used to induce ovulation in women with PCOS who desire to conceive 4, 3
Emerging Therapies for PCOS
Several emerging therapies have been identified for the treatment of PCOS, including:
- Inositol and alpha-lipoic acid, which have been shown to improve ovulation and insulin sensitivity 2, 5
- Glucagon-like peptide-1 (GLP-1) receptor agonists, which have been shown to improve insulin sensitivity and reduce androgen levels 5
- Dipeptidyl peptidase-4 (DPP-4) inhibitors and sodium-glucose transport protein 2 (SGLT2) inhibitors, which have been shown to improve insulin sensitivity and reduce androgen levels 5
- Vitamin D and statins, which have been shown to improve insulin sensitivity and reduce androgen levels 5
- Novel cosmetic techniques, such as electrolysis and laser therapy, which can be used to treat hirsutism 5
- Alternative therapies, such as acupuncture and osteopathic manipulative therapy, which have been shown to improve symptoms of PCOS 6
Adjunctive Therapies for PCOS
Several adjunctive therapies have been identified for the treatment of PCOS, including:
- Supplements, such as green cardamom and cinnamon, which have been shown to improve metabolic dysfunction 6
- Hormonal therapies, such as Fezolinetant, which have been shown to suppress hyperandrogenism 6
- Medications, such as Liraglutide, which have been shown to improve weight loss and insulin sensitivity 6