From the Guidelines
Lifestyle intervention is the primary treatment for hirsutism in Polycystic Ovary Syndrome (PCOS).
Treatment Options
- Lifestyle modification, including diet and exercise, has been shown to be effective in improving hirsutism, as measured by the Ferriman-Gallwey score, with a mean difference of −1.19 [−2.35 to −0.03]; p = .04 1.
- This approach also improves other PCOS-related factors, such as total testosterone, weight, waist circumference, and insulin sensitivity.
- While bariatric surgery may be considered for some women with PCOS and excess weight, the current evidence is limited and susceptible to bias, and more research is needed to inform clinical recommendations 1.
Key Considerations
- Caution is recommended when interpreting the results of lifestyle intervention studies due to inconsistencies and methodological weaknesses 1.
- High-quality studies are needed to advance research in this area and provide more definitive evidence to inform clinical recommendations 1.
From the Research
Treatment Options for Hirsutism in PCOS
The treatment for hirsutism in Polycystic Ovary Syndrome (PCOS) involves a combination of pharmacological and non-pharmacological methods. The primary goal of treatment is to reduce androgen levels and alleviate the symptoms of hirsutism.
Pharmacological Treatments
- Combined oral contraceptives (COCs) are commonly used to suppress androgen excess and reduce hirsutism 2, 3, 4
- Antiandrogens such as cyproterone acetate, spironolactone, flutamide, and finasteride can be used to block androgen receptors and reduce hair growth 3, 4, 5
- Metformin, an insulin-sensitizing agent, can be used to reduce androgen secretion and improve insulin resistance 2, 4
- Gonadotropin-releasing hormone (GnRH) agonists can be used to suppress ovarian androgen secretion, but are typically reserved for severe cases due to potential side effects 3
Non-Pharmacological Treatments
- Lifestyle changes such as weight reduction and exercise can improve insulin resistance and reduce androgen levels 2, 4
- Laser treatment can be effective in reducing the severity of facial hair and alleviating depression and anxiety in women with PCOS 6
Treatment Approach
- The treatment approach should be individualized based on the severity of hirsutism, the presence of metabolic comorbidities, and the patient's personal preferences and values 2
- A combination of pharmacological and non-pharmacological treatments may be necessary to achieve optimal results 2, 3, 4
- Treatment should be maintained for at least 6-12 months to assess efficacy and adjust the treatment plan as needed 2