Materiały źródłowe

• #1 Drug Treatments for Polycystic Ovary Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0415/p671.html

  Polycystic ovary syndrome is a condition present in approximately 5 to 10 percent of women of childbearing age. Treatment should target specific manifestations and individualized patient goals. […] Lifestyle modifications should be used in addition to medical treatments for optimal results. […] Insulin-sensitizing agents are indicated for most women with polycystic ovary syndrome because they have positive effects on insulin resistance, menstrual irregularities, anovulation, hirsutism, and obesity. Metformin has the most data supporting its effectiveness. […] Metformin and clomiphene, alone or in combination, are first-line agents for ovulation induction. […] Insulin-sensitizing agents, oral contraceptives, spironolactone, and topical eflornithine can be used in patients with hirsutism.

• #2 Diagnosis and Treatment of Polycystic Ovary Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0715/p106.html

  Polycystic ovary syndrome is the most common endocrinopathy among reproductive-aged women in the United States, affecting approximately 7% of female patients. […] Treatment of polycystic ovary syndrome is individualized based on the patient’s presentation and desire for pregnancy. For patients who are overweight, weight loss is recommended. Clomiphene and letrozole are first-line medications for infertility. Metformin is the first-line medication for metabolic manifestations, such as hyperglycemia. Hormonal contraceptives are first-line therapy for irregular menses and dermatologic manifestations. […] Recent studies suggest that letrozole (Femara) is associated with higher live-birth and ovulation rates compared with clomiphene in patients with polycystic ovary syndrome. […] A calorie-restricted diet is recommended for all patients with PCOS who are overweight. Weight loss has been shown to have a positive effect on fertility and metabolic profile.

• #3 PCOS (Polycystic Ovary Syndrome): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/8316-polycystic-ovary-syndrome-pcos

  Polycystic ovary syndrome (PCOS) is a common condition that affects your hormones. Treatment for PCOS depends on if you wish to become pregnant. […] Your healthcare provider can treat PCOS based on your symptoms and if you wish to become pregnant. […] Your healthcare provider will determine treatment based on your symptoms, medical history and other health conditions, and if you want to get pregnant. Treatments can include medications, lifestyle changes or a combination of both. […] If you dont plan to become pregnant, treatments include: Hormonal birth control: Options include birth control pills, patches, shots, a vaginal ring or an intrauterine device (IUD). Hormonal birth control helps to regulate your menstrual cycle, some forms will also improve acne and help with excess hair growth.

• #4 A Review of Polycystic Ovary Syndrome Treatment

  https://www.uspharmacist.com/article/a-review-of-polycystic-ovary-syndrome-treatment

  Polycystic ovary syndrome (PCOS) is an endocrine disorder affecting about 10% of reproductive-age women as well as adolescents. […] Nonpharmacologic and pharmacologic therapies address the signs and symptoms and reduce metabolic complications. The 2023 PCOS guideline recommends therapies including healthy-lifestyle interventions, combined oral contraceptives, metformin, eflornithine, letrozole, and clomiphene. […] Although there is no cure for PCOS, appropriate therapy can improve the patients symptoms and quality of life. […] Treatment goals include blocking excessive androgen production, reducing insulin resistance (IR), maintaining a desirable weight, achieving regular menstrual cycles, correcting any infertility difficulties, and (if desired) preventing pregnancy. […] PCOS treatment is tailored to the patients specific signs and symptoms, whether dermatologic, reproductive, or metabolic.

• #5 A Review of Polycystic Ovary Syndrome Treatment

  https://www.uspharmacist.com/article/a-review-of-polycystic-ovary-syndrome-treatment

  Healthy lifestyle interventions are first-line therapy for PCOS and are imperative at all ages. […] For patients who are not overweight, adopting a healthy lifestyle and preventing weight gain should be emphasized. […] Pharmacologic therapy for PCOS addresses nonfertility and fertility issues, and the therapy plan will incorporate the patients goals and consider patient-specific signs and symptoms. […] COCP containing an estrogen and progestin are recommended first-line, in addition to lifestyle interventions, for menstrual-cycle regulation and hyperandrogenism in adults with PCOS. […] For PCOS, the use of metformin is recommended in addition to lifestyle interventions, as it has proven beneficial effects on blood glucose, weight, waist-to-hip ratio, testosterone, and triglycerides.

• #6 Polycystic ovary syndrome (PCOS) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pcos/diagnosis-treatment/drc-20353443

  PCOS treatment focuses on managing the things that are concerning you. This could include infertility, hirsutism, acne or obesity. Specific treatment might involve lifestyle changes or medication. […] Your health care provider may recommend weight loss through a low-calorie diet combined with moderate exercise activities. Even a modest reduction in your weight for example, losing 5% of your body weight might improve your condition. Losing weight may increase the effectiveness of medications your provider recommends for PCOS, and it can help with infertility. […] To regulate your periods, your health care provider might recommend: Combination birth control pills. Pills that contain both estrogen and progestin decrease androgen production and regulate estrogen. Regulating your hormones can lower your risk of endometrial cancer and correct irregular bleeding, excess hair growth and acne.

• #7

  https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/treatment/

  Polycystic ovary syndrome (PCOS) cannot be cured, but the symptoms can be managed. […] Treatment options can vary because someone with PCOS may experience a range of symptoms, or just 1. […] The main treatment options are discussed in more detail below. […] In overweight women, the symptoms and overall risk of developing long-term health problems from PCOS can be greatly improved by losing excess weight. […] Weight loss of just 5% can lead to a significant improvement in PCOS. […] A number of medicines are available to treat different symptoms associated with PCOS. […] The contraceptive pill may be recommended to induce regular periods, or periods may be induced using an intermittent course of progestogen tablets. […] A medicine called clomifene may be the first treatment recommended for women with PCOS who are trying to get pregnant.

• #8 Polycystic ovary syndrome (PCOS) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pcos/diagnosis-treatment/drc-20353443

  To help you ovulate so that you can become pregnant, your health care provider might recommend: Clomiphene. This oral anti-estrogen medication is taken during the first part of your menstrual cycle. […] To reduce excessive hair growth or improve acne, your health care provider might recommend: Birth control pills. These pills decrease androgen production that can cause excessive hair growth and acne. […] Weight loss can lower insulin and androgen levels. It also may restore ovulation. Ask your health care provider about a weight-control program, if you need one. Meet with a registered dietitian for help in reaching weight-loss goals. […] Exercise helps lower blood sugar levels. If you have PCOS, increasing your daily activity and getting regular exercise may treat or even prevent insulin resistance. Being active may also help you keep your weight under control and avoid developing diabetes.

• #9 Polycystic ovary syndrome (PCOS) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pcos/diagnosis-treatment/drc-20353443

  To help you ovulate so that you can become pregnant, your health care provider might recommend: Clomiphene. This oral anti-estrogen medication is taken during the first part of your menstrual cycle. […] To reduce excessive hair growth or improve acne, your health care provider might recommend: Birth control pills. These pills decrease androgen production that can cause excessive hair growth and acne. […] Weight loss can lower insulin and androgen levels. It also may restore ovulation. Ask your health care provider about a weight-control program, if you need one. Meet with a registered dietitian for help in reaching weight-loss goals. […] Exercise helps lower blood sugar levels. If you have PCOS, increasing your daily activity and getting regular exercise may treat or even prevent insulin resistance. Being active may also help you keep your weight under control and avoid developing diabetes.

• #10 What are the treatments for PCOS? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  https://www.nichd.nih.gov/health/topics/pcos/conditioninfo/treatments

  Research shows that, if a person with PCOS has overweight or obesity, losing a small amount of weight and being more physically active can minimize many PCOS symptoms and related health issues, especially cardiovascular risks. […] Weight loss can restore ovulation and help make menstrual cycles more regular, which can improve chances of pregnancy and overall health. […] For many women with PCOS, weight loss also reduces symptoms such as increased hair growth and acne. […] Oral contraceptives containing the hormones estrogen and progestin are the primary long-term treatment option for women with intact ovaries who have PCOS but do not wish to become pregnant. […] In women with PCOS, these hormones: Make menstrual periods more regular, Reduce the level of androgens, leading to lower androgen activity, Help clear acne and reduce increased hair growth.

• #11 What are the treatments for PCOS? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  https://www.nichd.nih.gov/health/topics/pcos/conditioninfo/treatments

  Research shows that, if a person with PCOS has overweight or obesity, losing a small amount of weight and being more physically active can minimize many PCOS symptoms and related health issues, especially cardiovascular risks. […] Weight loss can restore ovulation and help make menstrual cycles more regular, which can improve chances of pregnancy and overall health. […] For many women with PCOS, weight loss also reduces symptoms such as increased hair growth and acne. […] Oral contraceptives containing the hormones estrogen and progestin are the primary long-term treatment option for women with intact ovaries who have PCOS but do not wish to become pregnant. […] In women with PCOS, these hormones: Make menstrual periods more regular, Reduce the level of androgens, leading to lower androgen activity, Help clear acne and reduce increased hair growth.

• #12 Polycystic ovary syndrome (PCOS) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pcos/diagnosis-treatment/drc-20353443

  PCOS treatment focuses on managing the things that are concerning you. This could include infertility, hirsutism, acne or obesity. Specific treatment might involve lifestyle changes or medication. […] Your health care provider may recommend weight loss through a low-calorie diet combined with moderate exercise activities. Even a modest reduction in your weight for example, losing 5% of your body weight might improve your condition. Losing weight may increase the effectiveness of medications your provider recommends for PCOS, and it can help with infertility. […] To regulate your periods, your health care provider might recommend: Combination birth control pills. Pills that contain both estrogen and progestin decrease androgen production and regulate estrogen. Regulating your hormones can lower your risk of endometrial cancer and correct irregular bleeding, excess hair growth and acne.

• #13 Polycystic ovary syndrome (PCOS) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pcos/diagnosis-treatment/drc-20353443

  To help you ovulate so that you can become pregnant, your health care provider might recommend: Clomiphene. This oral anti-estrogen medication is taken during the first part of your menstrual cycle. […] To reduce excessive hair growth or improve acne, your health care provider might recommend: Birth control pills. These pills decrease androgen production that can cause excessive hair growth and acne. […] Weight loss can lower insulin and androgen levels. It also may restore ovulation. Ask your health care provider about a weight-control program, if you need one. Meet with a registered dietitian for help in reaching weight-loss goals. […] Exercise helps lower blood sugar levels. If you have PCOS, increasing your daily activity and getting regular exercise may treat or even prevent insulin resistance. Being active may also help you keep your weight under control and avoid developing diabetes.

• #14 Polycystic Ovary Syndrome (PCOS) Symptoms, Diagnosis, Treatment and Self-Care

  https://www.unitypoint.org/find-a-service/womens-health/polycystic-ovary-syndrome

  For patients with PCOS who are overweight, weight reduction is the initial recommended treatment. Even 5% weight loss can improve hormone imbalances and restore regular cycles. […] PCOS and proper nutrition also play a crucial role in this approach. While there are many online resources regarding PCOS diets, there isnt strong evidence a particular diet is superior for managing the condition. Therefore, its recommended to follow a generally healthy, anti-inflammatory diet, like the Mediterranean diet, which is proven to be beneficial for heart health, weight loss and longevity. […] Beyond diet and exercise, prioritizing good sleep and managing stress, including treating any underlying depression through counseling or therapy, can positively impact PCOS. If significant weight loss isnt achieved through these methods, a referral to a nutritionist or weight management clinic may be considered to explore options such as weight loss medications, like Ozempic, or surgery.

• #15 What are the treatments for PCOS? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  https://www.nichd.nih.gov/health/topics/pcos/conditioninfo/treatments

  Treatments for PCOS, its specific symptoms, and its associated health problems vary, but they may include medications, lifestyle changes, and ways to address increased hair growth and acne. […] The treatment(s) your health care provider suggests will depend on your symptoms, overall health, and plans for pregnancy. […] Because some of the common treatments for PCOS symptoms can prevent pregnancy or may harm the fetus during pregnancy, it’s important to discuss your fertility goals with your health care provider when discussing treatment options. […] Many of the treatments discussed are not approved by the U.S. Food and Drug Administration (FDA) specifically for treating PCOS, meaning they cannot cure or prevent the condition. However, your health care provider may recommend them to treat symptoms of PCOS, such as acne and irregular periods.

• #16 Drug Treatments for Polycystic Ovary Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0415/p671.html

  Polycystic ovary syndrome is a condition present in approximately 5 to 10 percent of women of childbearing age. Treatment should target specific manifestations and individualized patient goals. […] Lifestyle modifications should be used in addition to medical treatments for optimal results. […] Insulin-sensitizing agents are indicated for most women with polycystic ovary syndrome because they have positive effects on insulin resistance, menstrual irregularities, anovulation, hirsutism, and obesity. Metformin has the most data supporting its effectiveness. […] Metformin and clomiphene, alone or in combination, are first-line agents for ovulation induction. […] Insulin-sensitizing agents, oral contraceptives, spironolactone, and topical eflornithine can be used in patients with hirsutism.

• #17 What are the treatments for PCOS? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  https://www.nichd.nih.gov/health/topics/pcos/conditioninfo/treatments

  Research shows that, if a person with PCOS has overweight or obesity, losing a small amount of weight and being more physically active can minimize many PCOS symptoms and related health issues, especially cardiovascular risks. […] Weight loss can restore ovulation and help make menstrual cycles more regular, which can improve chances of pregnancy and overall health. […] For many women with PCOS, weight loss also reduces symptoms such as increased hair growth and acne. […] Oral contraceptives containing the hormones estrogen and progestin are the primary long-term treatment option for women with intact ovaries who have PCOS but do not wish to become pregnant. […] In women with PCOS, these hormones: Make menstrual periods more regular, Reduce the level of androgens, leading to lower androgen activity, Help clear acne and reduce increased hair growth.

• #18 Polycystic Ovarian Syndrome Medication: Hypoglycemic Agents, Antiandrogens, Topical Hair-Removal Agents, Oral Contraceptives, Selective Estrogen Receptor Modulators, Acne Agents, Topical

  https://emedicine.medscape.com/article/256806-medication

  Drugs used in the treatment of polycystic ovarian syndrome (PCOS) include metformin (off-label use), spironolactone, eflornithine (topical cream to treat hirsutism), and oral contraceptives. Oral contraceptives containing a combination of estrogen and progestin increase sex hormone-binding globulin (SHBG) levels and thereby reduce the free testosterone level. Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels are also suppressed. This restores cyclic exposure of the endometrium to estrogen-progestin, with the resumption of menstrual periods and decreased hirsutism. However, the use of oral contraceptives may be associated with an increased risk of thrombosis and metabolic abnormalities. […] The indications, contraindications, and adverse effects of metformin therapy should be carefully reviewed with the patient before such therapy is begun. In addition, women starting metformin therapy should be informed that such treatment may result in ovulatory menstrual cycles and increase the probability of pregnancy. It is worth noting that metformin has the potential to reduce preeclampsia and gestational diabetes in pregnant women with PCOS.

• #19 Patient education: Polycystic ovary syndrome (PCOS) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/polycystic-ovary-syndrome-pcos-beyond-the-basics

  Progestin — Another method to treat menstrual irregularity is to take a hormone called progestin (sample brand name: Provera) for 10 to 14 days every 1 to 3 months. This will induce a period in almost all females with PCOS, reducing the risk of overgrowth of endometrial cells thereby lowering the risk of endometrial hyperplasia, but it does not help with the cosmetic concerns (hirsutism and acne) and does not prevent pregnancy. It does reduce the risk of uterine cancer. […] Hair treatments — Excess hair growth on the face and/or other parts of the body can be removed by shaving or use of depilatories, electrolysis, or laser therapy. […] Weight loss — For females with PCOS who are overweight or obese, weight loss is one of the most effective approaches for managing insulin abnormalities, irregular menstrual periods, and other symptoms of PCOS.

• #20 Polycystic Ovary Syndrome (PCOS) – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/menstrual-abnormalities/polycystic-ovary-syndrome-pcos

  Treatment of polycystic ovary syndrome aims to […] Manage hormonal and metabolic abnormalities and thus reduce risks of estrogen excess (eg, endometrial hyperplasia) and androgen excess (eg, diabetes, cardiovascular disorders) […] Relieve symptoms […] Treat infertility. Hormonal medications are used to cause regular shedding of the endometrium and reduce the risk of endometrial hyperplasia and cancer. Women are usually given an intermittent progestin (eg, medroxyprogesterone 5 to 10 mg orally once a day for 10 to 14 days every 1 to 2 months) or combination oral contraceptives to. These treatments also reduce circulating androgens and usually help make menstrual cycles more regular. Hormonal contraceptives are first-line therapy for menstrual abnormalities, hirsutism, and acne in women who have PCOS and who do not desire pregnancy.

• #21 Drug Treatments for Polycystic Ovary Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0415/p671.html

  Polycystic ovary syndrome is a condition present in approximately 5 to 10 percent of women of childbearing age. Treatment should target specific manifestations and individualized patient goals. […] Lifestyle modifications should be used in addition to medical treatments for optimal results. […] Insulin-sensitizing agents are indicated for most women with polycystic ovary syndrome because they have positive effects on insulin resistance, menstrual irregularities, anovulation, hirsutism, and obesity. Metformin has the most data supporting its effectiveness. […] Metformin and clomiphene, alone or in combination, are first-line agents for ovulation induction. […] Insulin-sensitizing agents, oral contraceptives, spironolactone, and topical eflornithine can be used in patients with hirsutism.

• #22 What are the treatments for PCOS? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  https://www.nichd.nih.gov/health/topics/pcos/conditioninfo/treatments

  Insulin-sensitizing medications, such as metformin, are not FDA approved to treat PCOS, but may help reduce symptoms. […] Anti-androgen medications are not FDA approved to treat PCOS but may help reduce symptoms. […] Those who wish to remove or otherwise address unwanted hair or increased growth for personal aesthetic reasons can use the following methods instead of or in combination with other approaches: Daily application of an eflornithine cream slows hair growth, especially on the face, by blocking an enzyme hair needs to grow. […] Retinoids, antibacterial agents, and antibiotics are common ways to treat acne; the specific treatment recommended depends on the severity of the acne.

• #23 Drug Treatments for Polycystic Ovary Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0415/p671.html

  First-line agents for ovulation induction and treatment of infertility in patients with PCOS include metformin and clomiphene, alone or in combination, as well as rosiglitazone. […] Metformin improves insulin resistance in patients with PCOS and is probably the best agent to use. […] Metformin is probably the first-line medication for obesity or weight reduction in patients with PCOS. […] Metformin can improve menstrual irregularities in patients with PCOS. […] Treatments for hirsutism in women with PCOS are similar to those in women without PCOS. […] First-line agents include spironolactone and metformin, as well as eflornithine for facial hirsutism. […] Insulin-sensitizing agents, including metformin, acarbose, and rosiglitazone, may be used to treat hirsutism in women with PCOS.

• #24

  https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/treatment/

  If clomifene is unsuccessful in encouraging ovulation, another medicine called metformin may be recommended. […] Metformin can also have other long-term health benefits, such as lowering high cholesterol levels and reducing the risk of heart disease. […] The combined oral contraceptive pill is usually used to treat excessive hair growth (hirsutism) and hair loss (alopecia). […] If you have PCOS and medicines do not help you to get pregnant, you may be offered in vitro fertilisation (IVF) treatment. […] A minor surgical procedure called laparoscopic ovarian drilling (LOD) may be a treatment option for fertility problems associated with PCOS that do not respond to medicine. […] LOD has been found to lower levels of testosterone and luteinising hormone (LH), and raise levels of follicle-stimulating hormone (FSH).

• #25 A Review of Polycystic Ovary Syndrome Treatment

  https://www.uspharmacist.com/article/a-review-of-polycystic-ovary-syndrome-treatment

  Healthy lifestyle interventions are first-line therapy for PCOS and are imperative at all ages. […] For patients who are not overweight, adopting a healthy lifestyle and preventing weight gain should be emphasized. […] Pharmacologic therapy for PCOS addresses nonfertility and fertility issues, and the therapy plan will incorporate the patients goals and consider patient-specific signs and symptoms. […] COCP containing an estrogen and progestin are recommended first-line, in addition to lifestyle interventions, for menstrual-cycle regulation and hyperandrogenism in adults with PCOS. […] For PCOS, the use of metformin is recommended in addition to lifestyle interventions, as it has proven beneficial effects on blood glucose, weight, waist-to-hip ratio, testosterone, and triglycerides.

• #26 Drug Treatments for Polycystic Ovary Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0415/p671.html

  First-line agents for ovulation induction and treatment of infertility in patients with PCOS include metformin and clomiphene, alone or in combination, as well as rosiglitazone. […] Metformin improves insulin resistance in patients with PCOS and is probably the best agent to use. […] Metformin is probably the first-line medication for obesity or weight reduction in patients with PCOS. […] Metformin can improve menstrual irregularities in patients with PCOS. […] Treatments for hirsutism in women with PCOS are similar to those in women without PCOS. […] First-line agents include spironolactone and metformin, as well as eflornithine for facial hirsutism. […] Insulin-sensitizing agents, including metformin, acarbose, and rosiglitazone, may be used to treat hirsutism in women with PCOS.

• #27

  https://www2.hse.ie/conditions/polycystic-ovary-syndrome/treatment/

  All treatments for fertility problems must be supervised by a fertility expert who offers regular ultrasound checks. Do not take any of these medicines unsupervised. […] Medicines to control excessive hair growth (hirsutism) and hair loss (alopecia) include: oral contraceptive tablets, cyproterone acetate, spironolactone, finasteride. […] Medicines can treat some of the other PCOS symptoms. […] Laparoscopic ovarian drilling (LOD) is a minor surgery. It may be an option if fertility medicines do not improve your PCOS. […] LOD can: lower your testosterone and luteinising hormone (LH) levels, raise your follicle-stimulating hormone (FSH) levels.

• #28 What are the treatments for PCOS? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  https://www.nichd.nih.gov/health/topics/pcos/conditioninfo/treatments

  Insulin-sensitizing medications, such as metformin, are not FDA approved to treat PCOS, but may help reduce symptoms. […] Anti-androgen medications are not FDA approved to treat PCOS but may help reduce symptoms. […] Those who wish to remove or otherwise address unwanted hair or increased growth for personal aesthetic reasons can use the following methods instead of or in combination with other approaches: Daily application of an eflornithine cream slows hair growth, especially on the face, by blocking an enzyme hair needs to grow. […] Retinoids, antibacterial agents, and antibiotics are common ways to treat acne; the specific treatment recommended depends on the severity of the acne.

• #29 Polycystic Ovarian Syndrome Medication: Hypoglycemic Agents, Antiandrogens, Topical Hair-Removal Agents, Oral Contraceptives, Selective Estrogen Receptor Modulators, Acne Agents, Topical

  https://emedicine.medscape.com/article/256806-medication

  Women taking spironolactone require reliable contraception. An oral contraceptive is preferable, but if that form of contraception is contraindicated, another type of contraception should be used. […] Eflornithine is indicated for the reduction of unwanted facial hair in women. It interferes with ornithine decarboxylase (needed for hair growth) in skin hair follicles. Eflornithine does not have a depilatory action; instead, it appears to retard hair growth and improve appearance where applied. Improvement may be seen in as short a period as 4-8 weeks, although 6 months of treatment may be required. […] Oral contraceptive agents reduce the secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) from the pituitary gland by decreasing the amount of gonadotropin-releasing hormone (GnRH). All oral contraceptives decrease ovarian androgen production. By inhibiting gonadotropin secretion and, therefore, tertiary follicle development, ovarian secretion of testosterone and androstenedione is decreased. All oral contraceptives increase sex hormone-binding globulin (SHBG) and, therefore, reduce free testosterone. Evidence indicates that high doses of contraceptive progestins may inhibit 5-alpha reductase. Oral contraceptives also decrease the production of adrenal androgens, particularly dehydroepiandrosterone sulfate (DHEA-S). […] Restoration of regular menstrual cycles prevents endometrial hyperplasia associated with anovulation. Oral contraceptives also improve acne and hirsutism. […] Clomiphene acts directly by producing a surge of luteinizing hormone and could cause ovulation within days.

• #30 Polycystic ovary syndrome (PCOS) treatment, from self-care to medication | HealthPartners Blog

  https://www.healthpartners.com/blog/treatment-for-pcos/

  Polycystic ovary syndrome is one of the most common causes of infertility in women. […] When discussing your treatment, your doctor will ask about your pregnancy goals. If you hope to become pregnant, they will focus on a plan that helps your body ovulate regularly to increase your chances of conceiving. […] Doctors will use your pregnancy goals to recommend treatment options for PCOS-related infertility. […] Treatment options can include medications, intrauterine insemination and in vitro fertilization. […] To increase your chances of getting pregnant, doctors may prescribe ovulation medications that help your ovaries release eggs more regularly, including: Clomiphene, Letrozole, Gonadotropins. […] IUI is a fertility treatment where millions of sperm are placed artificially inseminated in the uterus.

• #31 Diagnosis and Treatment of Polycystic Ovary Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0715/p106.html

  Polycystic ovary syndrome is the most common endocrinopathy among reproductive-aged women in the United States, affecting approximately 7% of female patients. […] Treatment of polycystic ovary syndrome is individualized based on the patient’s presentation and desire for pregnancy. For patients who are overweight, weight loss is recommended. Clomiphene and letrozole are first-line medications for infertility. Metformin is the first-line medication for metabolic manifestations, such as hyperglycemia. Hormonal contraceptives are first-line therapy for irregular menses and dermatologic manifestations. […] Recent studies suggest that letrozole (Femara) is associated with higher live-birth and ovulation rates compared with clomiphene in patients with polycystic ovary syndrome. […] A calorie-restricted diet is recommended for all patients with PCOS who are overweight. Weight loss has been shown to have a positive effect on fertility and metabolic profile.

• #32 Recent Advances in the Management of Polycystic Ovary Syndrome: A Review Article

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9440853/

  Ovulation inducement is the cornerstone of treatment for infertile PCOS patients who want to become pregnant because 70% of women with PCOS have dysovulation or no ovulation. Clomiphene citrate is a selective estrogen receptor modulator (SERM). Clomid citrate (CC) is the drug of choice for ovulation induction in polycystic ovarian syndrome in adolescents. […] Aromatase inhibitors (AI)-letrozole is the most widely used non-steroidal selective AI for inducing ovulation. […] Insulin resistance treatment, including drugs and lifestyle changes, is critical for PCOS treatment. Metformin is a biguanide medication that has been proven to be both safe and effective. […] Inositol, a dietary supplement, aids insulin signalling. […] Statins have been shown to help with the treatment of PCOS. […] Spironolactone, flutamide, and finasteride are antigens that reduce hirsutism and acne problems in PCOS patients.

• #33 Drug Treatments for Polycystic Ovary Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0415/p671.html

  First-line agents for ovulation induction and treatment of infertility in patients with PCOS include metformin and clomiphene, alone or in combination, as well as rosiglitazone. […] Insulin-sensitizing agents, including metformin, rosiglitazone, and pioglitazone, have been effective in improving fertility and ovulation in women with PCOS. […] Metformin is probably the best choice because it may improve insulin resistance in addition to improving menstrual irregularities.

• #34 A Review of Polycystic Ovary Syndrome Treatment

  https://www.uspharmacist.com/article/a-review-of-polycystic-ovary-syndrome-treatment

  Letrozole and clomiphene citrate are the first- and second-line pharmacologic agents, respectively, recommended by the 2023 guideline for ovulation induction in anovulatory infertile women with PCOS who have no other fertility problems. […] Pharmacists can play a essential role in educating patients about PCOS and its therapies, and they should refer patients to an appropriate HCP to address PCOS-related signs and symptoms as well as potential complications.

• #35 Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome (2023) – practice guidance | American Society for Reproductive Medicine | ASRM

  https://www.asrm.org/practice-guidance/practice-committee-documents/recommendations-from-the-2023-international-evidence-based-guideline-for-the-assessment-and-management-of-polycystic-ovary-syndrome/

  Mechanical laser therapy is effective for hair reduction in some subgroups, whilst anti-androgens have a limited role where other therapies are ineffective or contraindicated. […] Letrozole is the preferred first line pharmacological infertility therapy, with clomiphene in combination with metformin; gonadotrophins or ovarian surgery primarily having a role as second line therapy. […] In vitro fertilization (IVF) could be offered, potentially with in vitro maturation, as third line therapy, where other ovulation induction therapies have failed and in the absence of an absolute indication for IVF in women with PCOS and anovulatory infertility.

• #36 Polycystic ovary syndrome (PCOS) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pcos/diagnosis-treatment/drc-20353443

  To help you ovulate so that you can become pregnant, your health care provider might recommend: Clomiphene. This oral anti-estrogen medication is taken during the first part of your menstrual cycle. […] To reduce excessive hair growth or improve acne, your health care provider might recommend: Birth control pills. These pills decrease androgen production that can cause excessive hair growth and acne. […] Weight loss can lower insulin and androgen levels. It also may restore ovulation. Ask your health care provider about a weight-control program, if you need one. Meet with a registered dietitian for help in reaching weight-loss goals. […] Exercise helps lower blood sugar levels. If you have PCOS, increasing your daily activity and getting regular exercise may treat or even prevent insulin resistance. Being active may also help you keep your weight under control and avoid developing diabetes.

• #37 Polycystic Ovary Syndrome (PCOS): Symptoms, Causes, Tests, and Treatment

  https://www.webmd.com/women/what-is-pcos

  It’s possible to get pregnant when you have PCOS. But you might need medication to help you ovulate or use fertility technologies such as in vitro fertilization. […] If you need help ovulating to get pregnant, certain medicines may help: […] Clomiphene (Clomid, Serophene), an antiestrogen drug you take at the beginning of your cycle. […] If clomiphene doesn’t help with ovulation, you may be prescribed the diabetes drug metformin. […] If clomiphene and metformin don’t work, your doctor may prescribe hormonal medications called gonadotropins. You get this medicine in a shot. […] Letrozole (Femara), which is sometimes used when other medications don’t work. […] A procedure called ovarian drilling might make your ovaries work better when ovulation medications don’t. But doctors do it less often than they used to, as better medications are available now. The surgeon makes a small cut in your belly and removes the parts of your ovaries that make too many androgens.

• #38 Drug Treatments for Polycystic Ovary Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2009/0415/p671.html

  Polycystic ovary syndrome is a condition present in approximately 5 to 10 percent of women of childbearing age. Treatment should target specific manifestations and individualized patient goals. […] Lifestyle modifications should be used in addition to medical treatments for optimal results. […] Insulin-sensitizing agents are indicated for most women with polycystic ovary syndrome because they have positive effects on insulin resistance, menstrual irregularities, anovulation, hirsutism, and obesity. Metformin has the most data supporting its effectiveness. […] Metformin and clomiphene, alone or in combination, are first-line agents for ovulation induction. […] Insulin-sensitizing agents, oral contraceptives, spironolactone, and topical eflornithine can be used in patients with hirsutism.

• #39 Polycystic Ovary Syndrome (PCOS): Symptoms, Causes, Tests, and Treatment

  https://www.webmd.com/women/what-is-pcos

  It’s possible to get pregnant when you have PCOS. But you might need medication to help you ovulate or use fertility technologies such as in vitro fertilization. […] If you need help ovulating to get pregnant, certain medicines may help: […] Clomiphene (Clomid, Serophene), an antiestrogen drug you take at the beginning of your cycle. […] If clomiphene doesn’t help with ovulation, you may be prescribed the diabetes drug metformin. […] If clomiphene and metformin don’t work, your doctor may prescribe hormonal medications called gonadotropins. You get this medicine in a shot. […] Letrozole (Femara), which is sometimes used when other medications don’t work. […] A procedure called ovarian drilling might make your ovaries work better when ovulation medications don’t. But doctors do it less often than they used to, as better medications are available now. The surgeon makes a small cut in your belly and removes the parts of your ovaries that make too many androgens.

• #40 Patient education: Polycystic ovary syndrome (PCOS) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/polycystic-ovary-syndrome-pcos-beyond-the-basics

  Metformin — Metformin (sample brand name: Glucophage) is a medication that improves the effectiveness of insulin produced by the body, reducing insulin resistance and hyperinsulinemia. […] Treatment of infertility — If tests determine that lack of ovulation is the cause of infertility, several treatment options are available. These treatments work best in females who are not obese. […] A treatment option for females who are unable to become pregnant and who have PCOS is weight loss. Even a modest amount of weight loss may allow the female to begin ovulating normally. In addition, weight loss can improve the effectiveness of other infertility treatments. […] Letrozole is a medication that is now used to induce ovulation in females with PCOS. Studies have shown that live birth rates are higher in obese females with PCOS when they are treated with letrozole rather than clomiphene, the drug used in the past. Many experts now recommend letrozole as the first choice of treatment for females with PCOS who want to conceive.

• #41 Polycystic ovary syndrome (PCOS) treatment, from self-care to medication | HealthPartners Blog

  https://www.healthpartners.com/blog/treatment-for-pcos/

  IVF may be an option for PCOS-caused infertility if more conservative treatments dont work. […] If getting pregnant isnt part of your plans ever or in the near future, doctors may prescribe a series of medications to regulate your hormones and manage your PCOS. […] Hormonal birth control can be an effective, short- or long-term treatment for polycystic ovary syndrome in women who dont want to become pregnant now or in the future. […] Your doctor may prescribe diabetes medication because PCOS can impact the pancreas just like diabetes. […] To treat your PCOS symptoms, your doctor may prescribe hormone blockers like anti-androgen medicines. […] There are several options available for treating polycystic ovary syndrome.

• #42 Polycystic Ovary Syndrome (PCOS) > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/polycystic-ovary-syndrome

  Anti-androgens are utilized, often in combination with birth control pills, for women whose symptoms of hair excess and/or acne are not controlled with the use of birth control pill alone. […] The Yale Medicine team will also help patients lose weight and manage any cosmetic concerns, such as facial hair. […] For the overweight to obese women who might want to become pregnant, the first line intervention will be weight loss. […] Studies show that as many as 70 percent of women with PCOS have fertility problems. […] Women consult with a fertility expert to discuss treatment options, which may include common fertility medications, or the newer class of medications (aromatase inhibitors) that has shown better results in achieving ovulation in women with PCOS. […] Other options include advanced fertility treatments that utilize injectable hormones or intrauterine insemination.

• #43 Polycystic ovary syndrome (PCOS) treatment, from self-care to medication | HealthPartners Blog

  https://www.healthpartners.com/blog/treatment-for-pcos/

  Polycystic ovary syndrome is one of the most common causes of infertility in women. […] When discussing your treatment, your doctor will ask about your pregnancy goals. If you hope to become pregnant, they will focus on a plan that helps your body ovulate regularly to increase your chances of conceiving. […] Doctors will use your pregnancy goals to recommend treatment options for PCOS-related infertility. […] Treatment options can include medications, intrauterine insemination and in vitro fertilization. […] To increase your chances of getting pregnant, doctors may prescribe ovulation medications that help your ovaries release eggs more regularly, including: Clomiphene, Letrozole, Gonadotropins. […] IUI is a fertility treatment where millions of sperm are placed artificially inseminated in the uterus.

• #44 Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome (2023) – practice guidance | American Society for Reproductive Medicine | ASRM

  https://www.asrm.org/practice-guidance/practice-committee-documents/recommendations-from-the-2023-international-evidence-based-guideline-for-the-assessment-and-management-of-polycystic-ovary-syndrome/

  Mechanical laser therapy is effective for hair reduction in some subgroups, whilst anti-androgens have a limited role where other therapies are ineffective or contraindicated. […] Letrozole is the preferred first line pharmacological infertility therapy, with clomiphene in combination with metformin; gonadotrophins or ovarian surgery primarily having a role as second line therapy. […] In vitro fertilization (IVF) could be offered, potentially with in vitro maturation, as third line therapy, where other ovulation induction therapies have failed and in the absence of an absolute indication for IVF in women with PCOS and anovulatory infertility.

• #45

  https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/treatment/

  If clomifene is unsuccessful in encouraging ovulation, another medicine called metformin may be recommended. […] Metformin can also have other long-term health benefits, such as lowering high cholesterol levels and reducing the risk of heart disease. […] The combined oral contraceptive pill is usually used to treat excessive hair growth (hirsutism) and hair loss (alopecia). […] If you have PCOS and medicines do not help you to get pregnant, you may be offered in vitro fertilisation (IVF) treatment. […] A minor surgical procedure called laparoscopic ovarian drilling (LOD) may be a treatment option for fertility problems associated with PCOS that do not respond to medicine. […] LOD has been found to lower levels of testosterone and luteinising hormone (LH), and raise levels of follicle-stimulating hormone (FSH).

• #46

  https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/

  Polycystic ovary syndrome (PCOS) is a common condition that affects how a woman’s ovaries work. […] There’s no cure for PCOS, but the symptoms can be treated. Speak to a GP if you think you may have the condition. […] If you have PCOS and you’re overweight, losing weight and eating a healthy, balanced diet can make some symptoms better. […] Medicines are also available to treat symptoms such as excessive hair growth, irregular periods and fertility problems. […] If fertility medicines are not effective, a simple surgical procedure called laparoscopic ovarian drilling (LOD) may be recommended. […] This involves using heat or a laser to destroy the tissue in the ovaries that’s producing androgens, such as testosterone. […] With treatment, most women with PCOS are able to get pregnant.

• #47

  https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/treatment/

  If clomifene is unsuccessful in encouraging ovulation, another medicine called metformin may be recommended. […] Metformin can also have other long-term health benefits, such as lowering high cholesterol levels and reducing the risk of heart disease. […] The combined oral contraceptive pill is usually used to treat excessive hair growth (hirsutism) and hair loss (alopecia). […] If you have PCOS and medicines do not help you to get pregnant, you may be offered in vitro fertilisation (IVF) treatment. […] A minor surgical procedure called laparoscopic ovarian drilling (LOD) may be a treatment option for fertility problems associated with PCOS that do not respond to medicine. […] LOD has been found to lower levels of testosterone and luteinising hormone (LH), and raise levels of follicle-stimulating hormone (FSH).

• #48 Polycystic Ovary Syndrome (PCOS) – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/menstrual-abnormalities/polycystic-ovary-syndrome-pcos

  If clomiphene and other medications are unsuccessful or if there are other indications for laparoscopy, laparoscopic ovarian drilling may be considered; however possible long-term complications of drilling (eg, adhesions, ovarian insufficiency) must be considered. […] In adult women who do not desire pregnancy, hormone therapy that decreases androgen levels or spironolactone can be tried. Spironolactone 50 to 100 mg twice a day is effective, but because this medication may have teratogenic effects, effective contraception is needed. […] GnRH agonists and antagonists are being studied as treatment for unwanted body hair. […] Acne can be treated with the usual medications (eg, benzoyl peroxide, tretinoin cream, topical and oral antibiotics). Systemic isotretinoin is used only for severe cases.

• #49 PCOS | Polycystic Ovary Syndrome | MedlinePlus

  https://medlineplus.gov/polycysticovarysyndrome.html

  There is no cure for PCOS, but treatments can help you manage your symptoms. The treatments may include: […] Lifestyle changes, which can help reduce many symptoms. They can also lower your risk for or help manage related health problems. These changes include: Maintaining a healthy weight, Getting regular physical activity, Eating healthy foods. […] Medicines: Hormonal birth control, such as pills, shots, and IUDs, can make your period more regular. They may also help remove acne and extra facial and body hair. […] Anti-androgen medicines, which block the effect of androgens. This can help reduce hair loss on your head, the growth of facial and body hair, and acne. […] Insulin-sensitizing medicines, which are medicines that are used to treat type 2 diabetes. They improve insulin resistance and keep your blood glucose levels steady. They may also lower your androgen levels.

• #50 PCOS | Polycystic Ovary Syndrome | MedlinePlus

  https://medlineplus.gov/polycysticovarysyndrome.html

  Medicines for acne. These medicines come in pills, creams, or gels. […] Treatments for hair removal, such as facial hair removal creams, laser hair removal, and electrolysis. […] Fertility treatments if you are having trouble getting pregnant. They include medicines and procedures such as in vitro fertilization (IVF).

• #51 Diagnosis and Treatment of Polycystic Ovary Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0715/p106.html

  In a patient not seeking pregnancy, the Endocrine Society recommends hormonal contraception (i.e., oral contraceptive, dermal patch, or vaginal ring) as the initial medication for treatment of irregular menses and hyperandrogenism manifesting as acne or hirsutism. […] Hirsutism is a bothersome hyperandrogenic manifestation of PCOS that may require at least six months of treatment before improvement begins. According to a 2015 Cochrane review, the most effective first-line therapy for mild hirsutism is oral contraceptives. […] Acne is common in the general population and in patients with PCOS. Hormonal contraceptives are first-line medications for treating acne associated with PCOS and can be used in conjunction with standard topical acne therapy (e.g., retinoids, antibiotics, benzoyl peroxide) or as monotherapy.

• #52 Recent Advances in the Management of Polycystic Ovary Syndrome: A Review Article

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9440853/

  Ovulation inducement is the cornerstone of treatment for infertile PCOS patients who want to become pregnant because 70% of women with PCOS have dysovulation or no ovulation. Clomiphene citrate is a selective estrogen receptor modulator (SERM). Clomid citrate (CC) is the drug of choice for ovulation induction in polycystic ovarian syndrome in adolescents. […] Aromatase inhibitors (AI)-letrozole is the most widely used non-steroidal selective AI for inducing ovulation. […] Insulin resistance treatment, including drugs and lifestyle changes, is critical for PCOS treatment. Metformin is a biguanide medication that has been proven to be both safe and effective. […] Inositol, a dietary supplement, aids insulin signalling. […] Statins have been shown to help with the treatment of PCOS. […] Spironolactone, flutamide, and finasteride are antigens that reduce hirsutism and acne problems in PCOS patients.

• #53 What are the treatments for PCOS? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  https://www.nichd.nih.gov/health/topics/pcos/conditioninfo/treatments

  Insulin-sensitizing medications, such as metformin, are not FDA approved to treat PCOS, but may help reduce symptoms. […] Anti-androgen medications are not FDA approved to treat PCOS but may help reduce symptoms. […] Those who wish to remove or otherwise address unwanted hair or increased growth for personal aesthetic reasons can use the following methods instead of or in combination with other approaches: Daily application of an eflornithine cream slows hair growth, especially on the face, by blocking an enzyme hair needs to grow. […] Retinoids, antibacterial agents, and antibiotics are common ways to treat acne; the specific treatment recommended depends on the severity of the acne.

• #54 Polycystic Ovarian Syndrome Treatment & Management: Approach Considerations, Lifestyle Modifications, Drug Treatment

  https://emedicine.medscape.com/article/256806-treatment

  First-line medical therapy usually consists of an oral contraceptive to induce regular menses. […] If symptoms such as hirsutism are not sufficiently alleviated, an androgen-blocking agent may be added. […] First-line treatment for ovulation induction when fertility is desired is clomiphene citrate. […] Evidence suggests that metformin frequently, but not universally, improves ovulation rates and pregnancy rates in women with polycystic ovarian syndrome (PCOS), especially in obese women. […] A study found that N-acetylcysteine may enhance the effect of clomiphene citrate in inducing ovulation in patients with PCOS. […] A clear primary treatment for hirsutism in women with polycystic ovarian syndrome (PCOS) remains lacking. […] However, short-term, nonpharmacologic treatments of hirsutism include shaving and the use of chemical depilatories and/or bleaching cream.

• #55 PCOS Treatment & Services – UChicago Medicine

  https://www.uchicagomedicine.org/conditions-services/endocrinology-metabolic-disorders/polycystic-ovary-syndrome/pcos-treatment-services

  Losing weight can be quite challenging for women with PCOS. UChicago Medicine’s Weight Management Program can help women with PCOS identify an approach that works best for them. Many women with PCOS follow a low-carbohydrate diet designed to lose or maintain their weight. […] Electrolysis can eliminate or decrease unwanted hair. During electrolysis, individual hair follicles are destroyed by using an electric current. […] The removal of body hair through the use of laser treatment appears to be both effective and permanent.

• #56 PCOS Treatment & Services – UChicago Medicine

  https://www.uchicagomedicine.org/conditions-services/endocrinology-metabolic-disorders/polycystic-ovary-syndrome/pcos-treatment-services

  Losing weight can be quite challenging for women with PCOS. UChicago Medicine’s Weight Management Program can help women with PCOS identify an approach that works best for them. Many women with PCOS follow a low-carbohydrate diet designed to lose or maintain their weight. […] Electrolysis can eliminate or decrease unwanted hair. During electrolysis, individual hair follicles are destroyed by using an electric current. […] The removal of body hair through the use of laser treatment appears to be both effective and permanent.

• #57 Diagnosis and Treatment of Polycystic Ovary Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0715/p106.html

  In a patient not seeking pregnancy, the Endocrine Society recommends hormonal contraception (i.e., oral contraceptive, dermal patch, or vaginal ring) as the initial medication for treatment of irregular menses and hyperandrogenism manifesting as acne or hirsutism. […] Hirsutism is a bothersome hyperandrogenic manifestation of PCOS that may require at least six months of treatment before improvement begins. According to a 2015 Cochrane review, the most effective first-line therapy for mild hirsutism is oral contraceptives. […] Acne is common in the general population and in patients with PCOS. Hormonal contraceptives are first-line medications for treating acne associated with PCOS and can be used in conjunction with standard topical acne therapy (e.g., retinoids, antibiotics, benzoyl peroxide) or as monotherapy.

• #58 Diagnosis and Treatment of Polycystic Ovary Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0715/p106.html

  In a patient not seeking pregnancy, the Endocrine Society recommends hormonal contraception (i.e., oral contraceptive, dermal patch, or vaginal ring) as the initial medication for treatment of irregular menses and hyperandrogenism manifesting as acne or hirsutism. […] Hirsutism is a bothersome hyperandrogenic manifestation of PCOS that may require at least six months of treatment before improvement begins. According to a 2015 Cochrane review, the most effective first-line therapy for mild hirsutism is oral contraceptives. […] Acne is common in the general population and in patients with PCOS. Hormonal contraceptives are first-line medications for treating acne associated with PCOS and can be used in conjunction with standard topical acne therapy (e.g., retinoids, antibiotics, benzoyl peroxide) or as monotherapy.

• #59 PCOS | Polycystic Ovary Syndrome | MedlinePlus

  https://medlineplus.gov/polycysticovarysyndrome.html

  There is no cure for PCOS, but treatments can help you manage your symptoms. The treatments may include: […] Lifestyle changes, which can help reduce many symptoms. They can also lower your risk for or help manage related health problems. These changes include: Maintaining a healthy weight, Getting regular physical activity, Eating healthy foods. […] Medicines: Hormonal birth control, such as pills, shots, and IUDs, can make your period more regular. They may also help remove acne and extra facial and body hair. […] Anti-androgen medicines, which block the effect of androgens. This can help reduce hair loss on your head, the growth of facial and body hair, and acne. […] Insulin-sensitizing medicines, which are medicines that are used to treat type 2 diabetes. They improve insulin resistance and keep your blood glucose levels steady. They may also lower your androgen levels.

• #60 Diagnosis and Treatment of Polycystic Ovary Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0715/p106.html

  In a patient not seeking pregnancy, the Endocrine Society recommends hormonal contraception (i.e., oral contraceptive, dermal patch, or vaginal ring) as the initial medication for treatment of irregular menses and hyperandrogenism manifesting as acne or hirsutism. […] Hirsutism is a bothersome hyperandrogenic manifestation of PCOS that may require at least six months of treatment before improvement begins. According to a 2015 Cochrane review, the most effective first-line therapy for mild hirsutism is oral contraceptives. […] Acne is common in the general population and in patients with PCOS. Hormonal contraceptives are first-line medications for treating acne associated with PCOS and can be used in conjunction with standard topical acne therapy (e.g., retinoids, antibiotics, benzoyl peroxide) or as monotherapy.

• #61 What are the treatments for PCOS? | NICHD – Eunice Kennedy Shriver National Institute of Child Health and Human Development

  https://www.nichd.nih.gov/health/topics/pcos/conditioninfo/treatments

  Insulin-sensitizing medications, such as metformin, are not FDA approved to treat PCOS, but may help reduce symptoms. […] Anti-androgen medications are not FDA approved to treat PCOS but may help reduce symptoms. […] Those who wish to remove or otherwise address unwanted hair or increased growth for personal aesthetic reasons can use the following methods instead of or in combination with other approaches: Daily application of an eflornithine cream slows hair growth, especially on the face, by blocking an enzyme hair needs to grow. […] Retinoids, antibacterial agents, and antibiotics are common ways to treat acne; the specific treatment recommended depends on the severity of the acne.

• #62 Polycystic Ovary Syndrome (PCOS) – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/menstrual-abnormalities/polycystic-ovary-syndrome-pcos

  If clomiphene and other medications are unsuccessful or if there are other indications for laparoscopy, laparoscopic ovarian drilling may be considered; however possible long-term complications of drilling (eg, adhesions, ovarian insufficiency) must be considered. […] In adult women who do not desire pregnancy, hormone therapy that decreases androgen levels or spironolactone can be tried. Spironolactone 50 to 100 mg twice a day is effective, but because this medication may have teratogenic effects, effective contraception is needed. […] GnRH agonists and antagonists are being studied as treatment for unwanted body hair. […] Acne can be treated with the usual medications (eg, benzoyl peroxide, tretinoin cream, topical and oral antibiotics). Systemic isotretinoin is used only for severe cases.

• #63 Polycystic Ovary Syndrome (PCOS) – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/menstrual-abnormalities/polycystic-ovary-syndrome-pcos

  If clomiphene and other medications are unsuccessful or if there are other indications for laparoscopy, laparoscopic ovarian drilling may be considered; however possible long-term complications of drilling (eg, adhesions, ovarian insufficiency) must be considered. […] In adult women who do not desire pregnancy, hormone therapy that decreases androgen levels or spironolactone can be tried. Spironolactone 50 to 100 mg twice a day is effective, but because this medication may have teratogenic effects, effective contraception is needed. […] GnRH agonists and antagonists are being studied as treatment for unwanted body hair. […] Acne can be treated with the usual medications (eg, benzoyl peroxide, tretinoin cream, topical and oral antibiotics). Systemic isotretinoin is used only for severe cases.

• #64 Recent Advances in the Management of Polycystic Ovary Syndrome: A Review Article

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9440853/

  In the treatment of PCOS, the major mechanism of action of OCs is to control menstruation. […] PCOS patients who are unable to conceive and are not in danger of becoming pregnant, amenorrhea, or irregular uterine bleeding can be treated with medroxyprogesterone acetate (MPA). […] Orlistat is a weight-loss medicine that has been shown to work, but its effectiveness has been questioned. […] Vitamin D insufficiency or inadequacy affects 45-90% of reproductive-age women. According to research, vitamin D insufficiency was associated with a substantial reduction in ovulation rate, pregnancy rate, and the chance of a live delivery in PCOS women receiving ovarian stimulation for infertility. […] Before contemplating any pharmaceutical options, lifestyle changes should be considered the primary therapeutic prescription for PCOS-related infertility. Ovulation stimulation, which is best performed with letrozole, is the next phase, followed by CC. […] While insulin sensitizers such as metformin have long been used to treat PCOS metabolic dysfunction, newer medicines such as incretin mimetics and SGLT2 inhibitors have proven to be more effective at reducing weight and cardiovascular risk.

• #65 Recent Advances in the Management of Polycystic Ovary Syndrome: A Review Article

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9440853/

  Ovulation inducement is the cornerstone of treatment for infertile PCOS patients who want to become pregnant because 70% of women with PCOS have dysovulation or no ovulation. Clomiphene citrate is a selective estrogen receptor modulator (SERM). Clomid citrate (CC) is the drug of choice for ovulation induction in polycystic ovarian syndrome in adolescents. […] Aromatase inhibitors (AI)-letrozole is the most widely used non-steroidal selective AI for inducing ovulation. […] Insulin resistance treatment, including drugs and lifestyle changes, is critical for PCOS treatment. Metformin is a biguanide medication that has been proven to be both safe and effective. […] Inositol, a dietary supplement, aids insulin signalling. […] Statins have been shown to help with the treatment of PCOS. […] Spironolactone, flutamide, and finasteride are antigens that reduce hirsutism and acne problems in PCOS patients.

• #66 Pharmacological management of polycystic ovary syndrome – Australian Prescriber

  https://australianprescriber.tg.org.au/articles/pharmacological-management-of-polycystic-ovary-syndrome.html

  Anti-obesity drugs may be considered for weight management in addition to lifestyle interventions. […] The recommended preferences for pharmacological therapies for irregular periods, excess body weight and metabolic effects, and clinical hyperandrogenism are summarised in Table 1 and discussed in more detail in the individual sections on each therapy below. […] The combined oral contraceptive pill (COCP) is usually the first-line treatment to ameliorate symptoms of irregular periods or clinical hyperandrogenism, such as hirsutism or acne, in women with PCOS. […] In women with PCOS, metformin is used off label as first-line treatment for excess body weight and metabolic effects. Metformin can improve the underlying insulin resistance that is characteristic of PCOS. […] Inositol is a nutrient supplement that acts as an insulin sensitiser and is thought to promote glucose uptake and reduce androgen production in ovarian granulosa cells.

• #67

  https://www.nbcnews.com/health/womens-health/pcos-diagnosis-treatment-difficult-women-rcna142430

  Theres no magic pill, said Tallene Hacatoryan, 31, a registered dietician from Orange County, California. There are too many components for there to be a one-size-fits-all treatment. […] Doctors recommend hormonal contraceptives most commonly the birth control pill to regulate heavy, irregular periods;, acne;, and unwanted hair growth. […] PCOS is unfortunately not curable, so treatment is about managing its symptoms, said Dr. Jessica Chan, a reproductive endocrinologist at Cedars-Sinai. […] For women with PCOS whose main concerns are insulin resistance or stubborn weight gain, Chan often prescribes off-label diabetes medications like metformin. […] Some doctors who treat PCOS, including OB-GYNs or endocrinologists, have also begun prescribing GLP-1 agonists like Ozempic and Wegovy, which have shown promise for some women with PCOS, although studies have been small and early-stage.

• #68 Recent Advances in the Management of Polycystic Ovary Syndrome: A Review Article

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9440853/

  In the treatment of PCOS, the major mechanism of action of OCs is to control menstruation. […] PCOS patients who are unable to conceive and are not in danger of becoming pregnant, amenorrhea, or irregular uterine bleeding can be treated with medroxyprogesterone acetate (MPA). […] Orlistat is a weight-loss medicine that has been shown to work, but its effectiveness has been questioned. […] Vitamin D insufficiency or inadequacy affects 45-90% of reproductive-age women. According to research, vitamin D insufficiency was associated with a substantial reduction in ovulation rate, pregnancy rate, and the chance of a live delivery in PCOS women receiving ovarian stimulation for infertility. […] Before contemplating any pharmaceutical options, lifestyle changes should be considered the primary therapeutic prescription for PCOS-related infertility. Ovulation stimulation, which is best performed with letrozole, is the next phase, followed by CC. […] While insulin sensitizers such as metformin have long been used to treat PCOS metabolic dysfunction, newer medicines such as incretin mimetics and SGLT2 inhibitors have proven to be more effective at reducing weight and cardiovascular risk.

• #69 Recent Advances in the Management of Polycystic Ovary Syndrome: A Review Article

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9440853/

  Ovulation inducement is the cornerstone of treatment for infertile PCOS patients who want to become pregnant because 70% of women with PCOS have dysovulation or no ovulation. Clomiphene citrate is a selective estrogen receptor modulator (SERM). Clomid citrate (CC) is the drug of choice for ovulation induction in polycystic ovarian syndrome in adolescents. […] Aromatase inhibitors (AI)-letrozole is the most widely used non-steroidal selective AI for inducing ovulation. […] Insulin resistance treatment, including drugs and lifestyle changes, is critical for PCOS treatment. Metformin is a biguanide medication that has been proven to be both safe and effective. […] Inositol, a dietary supplement, aids insulin signalling. […] Statins have been shown to help with the treatment of PCOS. […] Spironolactone, flutamide, and finasteride are antigens that reduce hirsutism and acne problems in PCOS patients.

• #70 Recent Advances in the Management of Polycystic Ovary Syndrome: A Review Article

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9440853/

  In the treatment of PCOS, the major mechanism of action of OCs is to control menstruation. […] PCOS patients who are unable to conceive and are not in danger of becoming pregnant, amenorrhea, or irregular uterine bleeding can be treated with medroxyprogesterone acetate (MPA). […] Orlistat is a weight-loss medicine that has been shown to work, but its effectiveness has been questioned. […] Vitamin D insufficiency or inadequacy affects 45-90% of reproductive-age women. According to research, vitamin D insufficiency was associated with a substantial reduction in ovulation rate, pregnancy rate, and the chance of a live delivery in PCOS women receiving ovarian stimulation for infertility. […] Before contemplating any pharmaceutical options, lifestyle changes should be considered the primary therapeutic prescription for PCOS-related infertility. Ovulation stimulation, which is best performed with letrozole, is the next phase, followed by CC. […] While insulin sensitizers such as metformin have long been used to treat PCOS metabolic dysfunction, newer medicines such as incretin mimetics and SGLT2 inhibitors have proven to be more effective at reducing weight and cardiovascular risk.

• #71 Polycystic ovary syndrome (PCOS) – Los Angeles, CA | UCLA Health

  https://www.uclahealth.org/medical-services/obgyn/pcos

  We understand that PCOS affects every woman differently and can cause a wide range of symptoms. Our team develops a treatment plan based on your unique needs, lifestyle goals and pressing symptoms. […] UCLA Health experts are at the forefront of work to advance our understanding of PCOS and related conditions, such as infertility, obesity, diabetes and heart disease. Our Womens Reproductive Health Research Program provides women with PCOS the highest level of care and quality of life through research and investigation. Eligible patients can access the latest treatments in clinical trials at UCLA Health Obstetrics and Gynecology (OB/GYN). […] We understand that PCOS can lead to physical and mental health challenges, such as infertility and depression. Our skilled specialists take the time to get to know you as a person. Your care team addresses your whole health with skill and genuine concern for your well-being.

• #72 Polycystic Ovarian Syndrome (PCOS) Program > Departments > Yale Medicine

  https://www.yalemedicine.org/departments/polycystic-ovarian-syndrome-pcos-program

  Polycystic ovary syndrome (PCOS) is one of the most commonly misdiagnosed conditions associated with female infertility. […] Effective PCOS management typically requires a multidisciplinary approach involving primary care physicians (for general health, weight loss, diabetes risk, high blood pressure, and depression), gynecologists (for gynecological health and uterine lining protection), endocrinologists (for hormonal issues, including hair excess and acne, obesity, diabetes, and elevated cholesterol), and reproductive endocrinology and infertility specialists (for pregnancy goals). […] For overweight or obese women with PCOS, lifestyle modifications focusing on diet and exercise can lead to significant improvements in menstrual cycles, acne, and mood. Metformin, commonly prescribed for diabetes, may also benefit overweight or obese women with PCOS, as well as some undergoing fertility treatment.

• #73 Polycystic Ovary Syndrome (PCOS) – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/menstrual-abnormalities/polycystic-ovary-syndrome-pcos

  Because risk of depression and anxiety is increased in PCOS, women and adolescents with PCOS should be screened for these problems based on history, and if a problem is identified, they should be referred to a mental health care practitioner and/or treated as needed. […] Because PCOS can increase the risk of cardiovascular disorders, referral to a cardiovascular specialist for prevention of cardiovascular disorders is necessary if women with PCOS have any of the following: […] Clinicians should evaluate cardiovascular risk by determining body mass index (BMI), measuring fasting lipid and lipoprotein levels, and identifying risk factors for metabolic syndrome.

• #74 Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment | Nature Reviews Endocrinology

  https://www.nature.com/articles/nrendo.2018.24

  Polycystic ovary syndrome (PCOS) is defined by a combination of signs and symptoms of androgen excess and ovarian dysfunction in the absence of other specific diagnoses. […] Treatment should be symptom-oriented, long term and dynamic and adapted to the changing circumstances, personal needs and expectations of the individual patient. […] Therapeutic approaches should target hyperandrogenism, the consequences of ovarian dysfunction and/or the associated metabolic disorders. […] The diagnosis and treatment of PCOS are not complicated, requiring only the judicious application of a few well-standardized diagnostic methods and appropriate therapeutic approaches addressing hyperandrogenism, the consequences of ovarian dysfunction and the associated metabolic disorders. […] Lifestyle changes in women with polycystic ovary syndrome.

• #75 Patient education: Polycystic ovary syndrome (PCOS) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/polycystic-ovary-syndrome-pcos-beyond-the-basics

  Polycystic ovary syndrome (PCOS) is a condition that causes irregular menstrual periods, symptoms of excess androgens (acne, hirsutism, and scalp hair loss), and ovaries that appear „polycystic” on pelvic ultrasound. The condition occurs in approximately 5 to 10 percent of females. Many females with PCOS are overweight or obese, and they are at higher-than-average risk of developing type 2 diabetes, sleep apnea, fatty liver, and depression. For females with PCOS who want to become pregnant, fertility medications may be needed to induce ovulation. […] Although PCOS is not completely reversible, there are a number of treatments that can reduce or minimize bothersome symptoms. Most females with PCOS are able to lead a normal life without significant complications. […] PCOS TREATMENTS […] Oral contraceptives — Combination oral contraceptives (COCs; with combined estrogen and progestin) are the most commonly used treatment for regulating menstrual periods in females with PCOS. COCs are also effective for treating hirsutism and acne by suppressing ovarian androgen overproduction.

• #76 Polycystic ovary syndrome (PCOS) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439

  The exact cause of PCOS is unknown. Early diagnosis and treatment along with weight loss may lower the risk of long-term complications such as type 2 diabetes and heart disease. […] See your health care provider if you’re worried about your periods, if you’re having trouble getting pregnant, or if you have signs of excess androgen. […] Complications of PCOS can include infertility, gestational diabetes or pregnancy-induced high blood pressure, miscarriage or premature birth, nonalcoholic steatohepatitis, metabolic syndrome, type 2 diabetes or prediabetes, sleep apnea, depression, anxiety and eating disorders, and cancer of the uterine lining. […] Obesity commonly occurs with PCOS and can worsen complications of the disorder.

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