Procedure

Polycystic Ovary Syndrome (PCOS) Treatment- Endocrinology

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What is PCOS?

Polycystic ovary syndrome (PCOS), a hormonal disorder, affects 6–10% of women of reproductive age. It is characterized by clinical or biochemical hyperandrogenism (excess levels of androgen hormone) or irregular or long menstrual cycles. Ovaries, the reproductive organs (that produce estrogen and progesterone hormones) in women, are affected by PCOS affects a woman’s ovaries.

The common symptoms of PCOS include acne, hair growth, weight gain, heavy bleeding, irregular periods, polycystic ovaries, darkening of the skin etc.  In order to diagnose PCOS, pelvic exam, blood tests or an ultrasound may be recommended.

Which Speciality to Consult?

A gynecologist is the medical specialist who will diagnose and treat PCOS

Treatment:

Treatment for PCOS involves diet and lifestyle changes and medications.

Diet and lifestyle changes: The first step for the treatment for PCOS is changes in lifestyle that include exercise, diet, and weight loss. A diet with low-carbohydrates content as well as a low-calorie diet along with regular exercise may help to lose weight. Just by losing 5% of the body weight, a person’s condition may improve. Weight loss may help with infertility as well as may also help to increase the effectiveness of prescribed medicines for PCOS.

Medicines: Various medicines are prescribed to regulate menstrual cycle and ovulation.

Birth control pills and progestin therapy is recommended in order to regulate periods. Birth control pills which contain estrogen and progestin lead to a decrease in androgen production and regulate estrogen levels. Progestin tablets for 10 to 14 days every one to two months are also recommended to regulate periods.

In order to regulate ovulation, medicines such as clomiphene, letrozole, gonadotropins, metformin etc. may be prescribed. Clomiphene, an anti-estrogen medicine, is generally taken during the first part of the menstrual cycle. Letrozole, a medicine for the treatment of breast cancer, may also stimulate the ovaries. Metformin may be given along with clomiphene to regulate periods. Gonadotopin is generally given by an injection.

Medicines such as birth control pills, spironolactone, and eflornithine may help to reduce excessive hair growth.

Surgery: If none of the above mentioned medicines help to improve fertility, surgery may be a last option to treat PCOS. During the surgery called ovarian drilling, in order to restore normal ovulation, tiny holes are made in the ovary by using a laser or thin heated needle.

References:

  • https://www.ncbi.nlm.nih.gov/pubmed/30311070
  • https://www.mayoclinic.org/diseases-conditions/pcos/diagnosis-treatment/drc-20353443
  • https://www.healthline.com/health/polycystic-ovary-disease
About the Author:

Dr. Anand Lakhkar is a physician scientist from India. He completed his basic medical education from India and his postgraduate training in pharmacology from the United States. He has a MS degree in pharmacology from New York Medical College, a MS degree in Cancer/Neuro Pharmacology from Georgetown University and a PhD in Pharmacology from New York Medical College where he was the recipient of the Graduate Faculty Council Award for academic and research excellence.  His research area of expertise is in pulmonary hypertension, traumatic brain injury and cardiovascular pharmacology.  He has multiple publications in international peer-reviewed journals and has presented his research at at prestigious conferences.

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