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Polycystic ovary syndrome - Treatment

Alternative Names

Polycystic ovaries; Polycystic ovary disease; Stein-Leventhal syndrome; Polyfollicular ovarian disease

Treatment:

Losing weight (which can be difficult) has been shown to help with diabetes, high blood pressure, and high cholesterol. Even a weight loss of 5% of total body weight has been shown to help with the imbalance of hormones and also with infertility.

Medications used to treat the abnormal hormones and menstrual cycles of polycystic ovary syndrome include:

  • Birth control pills or progesterone pills, to help make menstrual cycles more regular
  • Metformin, a medication that increases the body's sensitivity to insulin, can improve the symptoms of PCOS and sometimes will cause the menstrual cycles to normalize. For some women, it can also help with weight loss.
  • LH-releasing hormone (LHRH) analogs

Treatment with clomiphene citrate causes the egg to mature and be released. Sometimes women need this or other fertility drugs to get pregnant.

Medications or other treatments for abnormal hair growth include:

  • Birth control pills. It may take several months to begin noticing a difference.
  • Anti-androgen medications, such as spironolactone and flutamide may be tried if birth control pills do not work.
  • Eflornithine cream may slow the growth of unwanted facial hair in women.
  • Hair removal using laser and nonlaser light sources damages individual hair follicles so they do not grow back. This can be expensive and multiple treatments are needed. Laser removal can be combined with other medicines and hormones.

Glucophage (Metformin), a medication that makes cells more sensitive to insulin, may help make ovulation and menstrual cycles more regular, prevent type 2 diabetes, and add to weight loss when a diet is followed.

Pelvic laparoscopy to remove a section of the ovary or drill holes in the ovaries is sometimes done to treat the absence of ovulation (anovulation) and infertility. The effects are temporary.

Expectations (prognosis):

Women who have this condition can get pregnant with the right surgical or medical treatments. Pregnancies are usually normal.

Complications:

  • Increased risk of endometrial cancer
  • Infertility (early treatment of polycystic ovary disease can help prevent infertility or increase the chance of having a healthy pregnancy)
  • Obesity-related (BMI over 30 and waist circumferance greater than 35) conditions, such as high blood pressure, heart problems, and diabetes
  • Possible increased risk of breast cancer

Calling your health care provider:

Call for an appointment with your health care provider if you have symptoms of this disorder.

  • Reviewed last on: 3/31/2010
  • Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond,Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Bulun SE, Adashi EY. The physiology and pathology of the female reporductive axis. In: Kronenberg HM, Melmed S, Polonsky KS, Larsen PR, eds. Williams Textbook of Endocrinology. 11th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 16.

Radosh L. Drug treatments for polycystic ovary syndrome. Am Fam Physician. 2009;79:671-676.

Lobo RA. Hyperandrogenism: Physiology, etiology, differential diagnosis, management. In: Katz VL, Lentz GM, Lobo RA, Gershenson DM, eds. Comprehensive Gynecology. 5th ed. Philadelphia, Pa: Mosby Elsevier;2007:chap 40.

ACOG Practice Bulletin Number 108, October 2009. Accessed March 31, 2010.

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