Treatment for PCOS
There is no cure for polycystic ovary syndrome (PCOS), but the symptoms can be managed. Since symptoms vary for different women with PCOS, it means treatment options differ. Below are the main treatment options.
For women who are overweight, the symptoms and risk of developing long-term health problems from PCOS can be improved by losing weight. Weight loss of just 5% can lead to a significant enhancement in PCOS.
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You can find out whether you’re a healthy weight by calculating your Body Mass Index (BMI), which is a measurement of your weight in relation to your height. Your diet should contain lots of fruits and vegetables, lean meats, chicken, fish and whole foods such as wholemeal bread, wholegrain cereals and brown rice. Your GP may be able to refer you to a dietitian if you need specific dietary advice.
A number of medications are available to treat different symptoms associated with PCOS. These are described below.
Irregular or absent periods
For this health issue, contraceptive pill may be recommended to induce regular periods. Also, periods may be induced using an intermittent course of progestogen tablets. This will also reduce the long-term risk of developing endometrial cancer associated with not having regular periods.
Most women with PCOS are able to get pregnant with treatment. The majority of women can be successfully treated with a short course of tablets taken at the beginning of each cycle for several cycles. If these aren’t successful, you may be offered injections or treatment. There’s an increased risk of multiple pregnancy with these treatments.
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A medication called clomifene is usually recommended for women with PCOS who are trying to conceive. Clomifene encourages the monthly release of an egg from the ovaries, a process called ovulation.
If clomifene failed, another medication called metformin may be recommended. Metformin is often used to treat type 2 diabetes. For women with PCOS, It can also lower insulin and blood sugar levels. Possible side effects of metformin include nausea, vomiting, loss of appetite, diarrhea, and stomach pain.
Also, instead of using clomifene to stimulate ovulation, letrozole and tamoxifen are sometimes used. Letrozole is licensed for treating breast cancer but doesn’t have a license for treating PCOS. Doctors sometimes use an unlicensed medication if they think it’s likely to be effective and the benefits of treatment outweigh any associated risks.
If you’re unable to get pregnant despite taking oral medications, a different type of medication called gonadotrophins may be recommended. These are given by injection and there’s a higher risk that they may overstimulate your ovaries and lead to multiple pregnancies.
An alternative to gonadotrophins is a surgical procedure called laparoscopic ovarian drilling (see below). This treatment can be as effective as using gonadotrophins, but it doesn’t increase your risk of multiple pregnancies.
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A fertility specialist will check your fallopian tubes to ensure they aren’t blocked before most of these treatments are used.
A minor surgical procedure called laparoscopic ovarian drilling (LOD) may be a treatment option for fertility problems associated with PCOS.
This procedure is done under general anaesthetic. Your doctor will make a small cut in your lower abdomen and pass a long, thin microscope called a laparoscope through into your abdomen. The ovaries will then be surgically treated using heat or a laser to destroy the tissue that’s producing androgens (male hormones).
LOD has been found to lower levels of testosterone and luteinising hormone (LH) and raise levels of follicle-stimulating hormone (FSH). This corrects your hormone imbalance and can restore the normal function of your ovaries.
Women with PCOS, have a higher risk of pregnancy complications, especially for obese women. Some of such risks include; high blood pressure, miscarriage, and gestational diabetes