Materiały źródłowe

• #1 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. Your health care provider and a registered dietitian can work with you to determine the best weight-loss plan. […] 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.

• #2

  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.

• #3 Treatment of polycystic ovary syndrome in adults – UpToDate

  https://www.uptodate.com/contents/treatment-of-polycystic-ovary-syndrome-in-adults

  Treatment of polycystic ovary syndrome in adults […] The treatment of PCOS will be reviewed here. […] Weight loss, which can restore ovulatory cycles and improve metabolic risk, is the first-line intervention for most women. […] The overall goals of therapy of women with PCOS include: […] Amelioration of hyperandrogenic features (hirsutism, acne, scalp hair loss) […] […] Women with PCOS have multiple abnormalities that require attention, including oligomenorrhea, hyperandrogenism, anovulatory infertility, and metabolic risk factors such as obesity, insulin resistance, dyslipidemia, and impaired glucose tolerance.

• #4 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.

• #5 Treatment options for polycystic ovary syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3039006/

  Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women. Management of women with PCOS depends on the symptoms. These could be ovulatory dysfunction-related infertility, menstrual disorders, or androgen-related symptoms. Weight loss improves the endocrine profile and increases the likelihood of ovulation and pregnancy. Normalization of menstrual cycles and ovulation could occur with modest weight loss as little as 5% of the initial weight. The treatment of obesity includes modifications in lifestyle (diet and exercise) and medical and surgical treatment. In PCOS, anovulation relates to low follicle-stimulating hormone concentrations and the arrest of antral follicle growth in the final stages of maturation. This can be treated with medications such as clomiphene citrate, tamoxifen, aromatase inhibitors, metformin, glucocorticoids, or gonadotropins or surgically by laparoscopic ovarian drilling. In vitro fertilization will remain the last option to achieve pregnancy when others fail. Chronic anovulation over a long period of time is also associated with an increased risk of endometrial hyperplasia and carcinoma, which should be seriously investigated and treated. There are androgenic symptoms that will vary from patient to patient, such as hirsutism, acne, and/or alopecia. These are troublesome presentations to the patients and require adequate treatment.

• #6 Treatment of polycystic ovary syndrome in adults – UpToDate

  https://www.uptodate.com/contents/treatment-of-polycystic-ovary-syndrome-in-adults

  Treatment of polycystic ovary syndrome in adults […] The treatment of PCOS will be reviewed here. […] Weight loss, which can restore ovulatory cycles and improve metabolic risk, is the first-line intervention for most women. […] The overall goals of therapy of women with PCOS include: […] Amelioration of hyperandrogenic features (hirsutism, acne, scalp hair loss) […] […] Women with PCOS have multiple abnormalities that require attention, including oligomenorrhea, hyperandrogenism, anovulatory infertility, and metabolic risk factors such as obesity, insulin resistance, dyslipidemia, and impaired glucose tolerance.

• #7 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. Your health care provider and a registered dietitian can work with you to determine the best weight-loss plan. […] 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.

• #8

  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.

• #9 Treatment options for polycystic ovary syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3039006/

  Management of women with PCOS depends on the symptoms. These could be ovulatory dysfunction-related infertility, menstrual disorders, or androgen-related symptoms. Weight loss improves the endocrine profile and increases the likelihood of ovulation and pregnancy. Normalization of the menstrual cycles and ovulation could occur with modest weight loss as little as 5% of the initial weight. The treatment of obesity includes modifications in lifestyle (diet and exercise) and medical and surgical treatment. […] In PCOS, anovulation relates to low FSH concentrations and the arrest of antral follicle growth in the final stages of maturation. Medications and other options available for the induction of ovulation are reviewed in the following sections. CC constitutes one of the first-line treatments for ovulation induction in these patients, as it is economical, is straightforward, has few adverse effects, and requires little monitoring. CC is an estrogen receptor antagonist that interferes with negative feedback of the estrogen-signaling pathway, resulting in increased availability of FSH. Increased FSH leads to follicular growth, followed by an LH surge and ovulation.

• #10 Diagnosing and treating PCOS | Jean Hailes

  https://www.jeanhailes.org.au/health-a-z/polycystic-ovary-syndrome/diagnosing-and-treating-pcos

  Research studies have shown that a weight reduction of 5% to 10% can: reduce insulin resistance by about 50%, restore ovulation, regulate menstrual cycles, improve fertility, reduce pregnancy complications, improve the health of mother and child during pregnancy, improve emotional health (self-esteem, anxiety, depression), reduce the risk of developing diabetes and heart disease. […] Symptoms of PCOS, such as excess hair growth and acne, can make you feel self-conscious, reduce your self-esteem and affect your body image and mood. […] More than 70% of women with PCOS in Australia use natural therapies to improve their symptoms and general wellbeing. […] Some studies found that inositol supplements may be effective for regulating menstrual cycles in people with PCOS. […] High levels of androgens can cause excess hair growth on the face and body, and severe acne (pimples). […] Low doses of vitamin D in women with a vitamin D deficiency may improve glucose metabolism and improve total cholesterol, LDL (bad) cholesterol and triglycerides in people with PCOS.

• #11 Polycystic ovary syndrome

  https://dermnetnz.org/topics/polycystic-ovary-syndrome

  In the past, management of the condition was directed at treating individual symptoms of PCOS, such as hirsutism, acne or fertility. More recently with the understanding that insulin resistance has a large part to play in the development of PCOS, treatment has shifted towards correcting insulin resistance, which in turn improves many other symptoms of the condition. […] Diet and exercise: weight loss in obese PCOS patients leads to decreased insulin resistance and a fall in testosterone levels. Outward improvements include reduced hirsutism and a return of menstrual cycles in some women. […] Metformin and newer glitazone antidiabetic medications decrease insulin resistance and the amount of insulin in the blood. They may also normalise ovulation. […] In addition to the above treatments, specific treatments are used to gain overall control of symptoms.

• #12 Diagnosing and treating PCOS | Jean Hailes

  https://www.jeanhailes.org.au/health-a-z/polycystic-ovary-syndrome/diagnosing-and-treating-pcos

  Research studies have shown that a weight reduction of 5% to 10% can: reduce insulin resistance by about 50%, restore ovulation, regulate menstrual cycles, improve fertility, reduce pregnancy complications, improve the health of mother and child during pregnancy, improve emotional health (self-esteem, anxiety, depression), reduce the risk of developing diabetes and heart disease. […] Symptoms of PCOS, such as excess hair growth and acne, can make you feel self-conscious, reduce your self-esteem and affect your body image and mood. […] More than 70% of women with PCOS in Australia use natural therapies to improve their symptoms and general wellbeing. […] Some studies found that inositol supplements may be effective for regulating menstrual cycles in people with PCOS. […] High levels of androgens can cause excess hair growth on the face and body, and severe acne (pimples). […] Low doses of vitamin D in women with a vitamin D deficiency may improve glucose metabolism and improve total cholesterol, LDL (bad) cholesterol and triglycerides in people with PCOS.

• #13 Diagnosing and treating PCOS | Jean Hailes

  https://www.jeanhailes.org.au/health-a-z/polycystic-ovary-syndrome/diagnosing-and-treating-pcos

  Research studies have shown that a weight reduction of 5% to 10% can: reduce insulin resistance by about 50%, restore ovulation, regulate menstrual cycles, improve fertility, reduce pregnancy complications, improve the health of mother and child during pregnancy, improve emotional health (self-esteem, anxiety, depression), reduce the risk of developing diabetes and heart disease. […] Symptoms of PCOS, such as excess hair growth and acne, can make you feel self-conscious, reduce your self-esteem and affect your body image and mood. […] More than 70% of women with PCOS in Australia use natural therapies to improve their symptoms and general wellbeing. […] Some studies found that inositol supplements may be effective for regulating menstrual cycles in people with PCOS. […] High levels of androgens can cause excess hair growth on the face and body, and severe acne (pimples). […] Low doses of vitamin D in women with a vitamin D deficiency may improve glucose metabolism and improve total cholesterol, LDL (bad) cholesterol and triglycerides in people with PCOS.

• #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 isn’t strong evidence a particular diet is superior for managing the condition. Therefore, it’s 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 isn’t 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 Polycystic Ovary Syndrome (PCOS): Symptoms, Causes, Tests, and Treatment

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

  Diet and Lifestyle Changes for PCOS and Fertility […] A healthy lifestyle that includes weight control, regular exercise, and blood sugar control can help improve your PCOS symptoms and your fertility. […] Managing weight […] Not everyone who has PCOS is overweight, but many are. Gaining a lot of weight can affect your hormones. If you’re obese or overweight, losing weight may help get your hormones back to normal levels. Losing just 10% of your body weight may help your menstrual cycle become more predictable. […] Your doctor may recommend choosing foods lower in calories and fat and controlling portion sizes. But losing weight isn’t easy. A nutritionist or dietitian may be able to help. Also, some people find that keeping a journal or using an app to track meals and snacks can make things easier.

• #16 What Is Polycystic Ovary Syndrome (PCOS)? Symptoms, Causes, Diagnosis, and Treatment

  https://www.everydayhealth.com/pcos/

  Getting more exercise can also improve symptoms of PCOS and help with weight loss. Health experts suggest that people with PCOS get 150 to 300 minutes of moderate-intensity exercise or 75 to 150 minutes of vigorous exercise each week. […] There are several other lifestyle factors beyond changing your diet, losing weight, and getting more exercise that may improve your PCOS symptoms.

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

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

  PCOS diet […] To manage your blood sugar, your doctor may suggest focusing on foods that are lower in sugar and certain carbohydrates (carbs). Some carbs are good for you, such as those in high-fiber vegetables and fruits. But it’s best to limit refined carbs, such as those found in white flour, white rice, white potatoes, sugar, and highly processed foods. These foods have a high glycemic index, which means they make your blood sugar rise quickly. […] Other healthy foods, such as poultry and other lean meats, fish, and whole grains, can help with your blood sugar levels, too. Try to have regular meals, as sticking to a schedule helps your body maintain consistent insulin levels. […] Exercising […] Regular exercise burns calories and increases muscle mass. This can help decrease insulin resistance, which can lower your androgen levels and help with symptoms. Exercise can also boost your mood and self-esteem.

• #18 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 isn’t strong evidence a particular diet is superior for managing the condition. Therefore, it’s 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 isn’t 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.

• #19 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 isn’t strong evidence a particular diet is superior for managing the condition. Therefore, it’s 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 isn’t 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.

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

  https://www.healthline.com/health/polycystic-ovary-disease

  Polycystic ovary syndrome is caused by an imbalance of androgens. Treatment options include hormonal birth control and the diabetes drug metformin. […] Birth control pills and diabetes drugs (which combat insulin resistance, a PCOS symptom) can help fix the hormone imbalance and improve symptoms. […] Treatment for PCOS usually starts with lifestyle changes like weight loss, diet, and exercise. […] Losing just 5 to 10 percent of your body weight can help regulate your menstrual cycle and improve PCOS symptoms. […] Studies comparing diets for PCOS have found that low carbohydrate diets are effective for both weight loss and lowering insulin levels. […] Birth control pills and other medications can help regulate the menstrual cycle and treat PCOS symptoms like hair growth and acne. […] Metformin (Glucophage, Fortamet) is a drug used to treat type 2 diabetes. It also treats PCOS by improving insulin levels.

• #21 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. Your health care provider and a registered dietitian can work with you to determine the best weight-loss plan. […] 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.

• #22 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.

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

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

  Polycystic ovary syndrome is a common and frequently undiagnosed female endocrine disorder that is associated with diverse symptoms and features, and an increased risk of long-term chronic diseases such as type 2 diabetes and cardiovascular disease. Pharmacotherapy for polycystic ovary syndrome should be directed at the key concerns of the individual patient. […] The combined oral contraceptive pill or metformin may be prescribed for irregular periods. The combined oral contraceptive pill is preferred over antiandrogens for treatment of hirsutism and acne. […] Metformin is of benefit for reducing excess body weight and improving hormonal and metabolic outcomes in those with high metabolic risk (e.g. body mass index greater than 25 kg/m2). […] Anti-obesity drugs may be considered for weight management in addition to lifestyle interventions.

• #24 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. […] 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. […] Insulin-sensitizing medications, such as metformin, are not FDA approved to treat PCOS, but may help reduce symptoms.

• #25 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

  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. […] 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.

• #26 PCOS Treatment & Services – UChicago Medicine

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

  Oral contraceptives (birth control pills) contain a combination of hormones (estrogen and progesterone). Used properly, oral contraceptives can ensure that women with PCOS menstruate every four weeks. This, in turn, lowers the risk of endometrial cancer, which is higher in women with PCOS because they do not menstruate regularly and properly shed the endometrial lining. […] Anti-androgenic agents, such as spironolactone, block the effect of androgens (male hormones, including testosterone). In high doses, anti-androgens can reduce unwanted hair growth and acne. […] Many assisted-reproduction techniques are available for women who have difficulty conceiving because of PCOS. Working with UChicago Medicine experts in reproductive endocrinology, the Center for Polycystic Ovary Syndrome offers a full spectrum of standard and innovative fertility therapies from oral and injectible medications that stimulate ovulation to advanced in vitro fertilization techniques, including use of donor eggs.

• #27 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. […] An oral contraceptive containing ethinyl estradiol and a progestin with minimal androgenic activity, such as norgestimate, norethindrone, or desogestrel, should be selected. Ethinyl estradiol combined with drospirenone (Yasmin) has a progestin that acts as an antiandrogen and thus may add antiandrogenic effects.

• #28 The Pathophysiological Mechanism and Clinical Treatment of Polycystic Ovary Syndrome: A Molecular and Cellular Review of the Literature

  https://www.mdpi.com/1422-0067/25/16/9037

  Pharmacologic intervention could be applied to various aspects of PCOS, such as improvement in hyperandrogenic manifestations, management of metabolic disorders, ovulation induction, etc. […] Antiandrogens reduce androgen levels and the action of testosterone by binding to androgen receptors, thus ameliorating physical conditions related to androgen excess such as hirsutism. […] Metformin is an old, cheap, safe biguanide drug with wide application through its action of improving insulin sensibility. […] Thiazolidinediones are another group of insulin sensitizers that could treat diabetes mellitus and obesity. […] One of the leading causes for female infertility though it may be, pregnancy can be achieved when ovulation is resumed. […] Combined oral contraceptives (COCs) are a common treatment of choice. COCs are composed of an estrogen component and a progesterone component. […] Surgical management remains to be a treatment option for PCOS, albeit not very popular. The most common procedures to enhance ovulation and pregnancy rates are laparoscopic ovarian drilling (LOD) and transvaginal hydrolaparoscopy (THL).

• #29 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

  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. Cyproterone, an antiandrogen (not available in the US), reduces the amount of unwanted body hair in 50 to 75% of affected women. Weight reduction decreases androgen production in women with obesity and thus may slow hair growth. […] GnRH agonists and antagonists are being studied as treatment for unwanted body hair. Both types of medications inhibit the production of sex hormones by the ovaries. But both can cause bone loss and lead to osteoporosis. […] 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.

• #30 Polycystic ovary syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Polycystic_ovary_syndrome

  Treatment involves management of symptoms using medication. […] Weight loss, exercise. […] Medication Birth control pills, metformin, GLP-1, anti-androgens. […] Birth control pills may help with improving the regularity of periods, excess hair growth, and acne. […] Metformin, GLP-1, and anti-androgens may also help. […] Efforts to improve fertility include weight loss, metformin, and ovulation induction using clomiphene or letrozole. […] In vitro fertilization is used by some in whom other measures are not effective. […] The primary treatments for PCOS include lifestyle changes and the use of medications. […] Goals of treatment may be considered under these categories: Lowering of insulin resistance, Reducing androgen and testosterone levels, Restoration of fertility, Treatment of hirsutism or acne, Restoration of regular menstruation, and prevention of endometrial hyperplasia and endometrial cancer.

• #31 Polycystic ovary syndrome – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/polycystic-ovary-syndrome/

  Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women. Management consists of lifestyle modifications combined with specific treatment, which is tailored to the patient’s reproductive goals. In women who do not wish to conceive, combined oral contraceptive pills are indicated to regulate menses and treat hyperandrogenism. For women who wish to conceive, the goal of treatment is to induce ovulation (e.g., with letrozole). […] For patients who do not wish to conceive, the therapeutic goals are to control menstrual irregularities and hyperandrogenism, treat comorbidities, and improve quality of life. Combined oral contraceptives (COCs) are the first-line treatment for hyperandrogenism and/or menstrual cycle abnormalities. Metformin improves menstrual irregularities, metabolic outcomes, and weight (especially when combined with lifestyle modifications). Letrozole is the first-line therapy for ovulation induction. Clomiphene is an alternative to letrozole. Exogenous gonadotropins are the second-line treatment for ovulation induction. Metformin can be used as second-line monotherapy for fertility treatment. Laparoscopic ovarian drilling is a second-line treatment for ovulation induction. In vitro fertilization can be offered as third-line therapy.

• #32 Treatment options for polycystic ovary syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3039006/

  In women who have no desire to conceive, they can be treated with oral contraceptive pills (OCPs). OCPs reduce hyperandrogenism by promoting direct negative feedback on LH secretion, which results in decreased ovarian synthesis of androgens. […] Antiandrogens such as spironolactone, CPA, or flutamide act by competitive inhibition of androgen-binding receptors or by decreasing androgen production. […] Some women with PCOS have elevated adrenal androgen levels, although their contribution to ovulatory dysfunction appears modest. Glucocorticoids suppress adrenal androgen secretion and have been used in patients with adrenal hyperandrogenism. […] Absence of evidence is not evidence of absence. Alternative medicine has been emerging as one of the commonly practiced medicines for different health problems. Alternative medicines include many modalities, such as kinesiology, herbalism, homeopathy, reflexology, acupressure, acupuncture, and massage therapy. Acupuncture is the most common modality. The benefit acupuncture seems to have for PCOS sufferers is in helping them regulate and manage their periods.

• #33 Polycystic ovary syndrome

  https://dermnetnz.org/topics/polycystic-ovary-syndrome

  Antiandrogenic oral contraceptives (birth control pills) help control acne and hirsutism. They also improve menstrual irregularities. They may be unsuitable for overweight or obese women. […] Spironolactone, a powerful antiandrogen, can reduce acne and also body hair growth over time. It is less effective for alopecia. It cannot be used by women who are trying to conceive as it can cause birth defects. […] Low dose glucocorticoids taken at night are suitable for some women. […] Gonadotrophin releasing hormone agonist medications are under investigation to inhibit pituitary release of LH and thus reduce the secretion of ovarian hormones. […] Isotretinoin is used for severe cases of acne. It cannot be used by women who are pregnant or trying to conceive as it can cause birth defects. PCOS may result in recurrence of acne after initial successful clearance with isotretinoin. […] Hair removal measures such as shaving, electrolysis, chemical and waxing creams can be used to treat hirsutism.

• #34 How Is Polycystic Ovary Syndrome (PCOS) Treated?

  https://www.everydayhealth.com/pcos/treatment-therapy-options/

  Polycystic ovary syndrome (PCOS) can be a daunting diagnosis to receive. The unfortunate truth is that there is no cure for PCOS. But because the disorder can have a profound effect on your health and well-being, treatment is a must. There is one important thing to know about your options: Because the cause of PCOS is still unknown, appropriate therapies are based on a woman’s individual concerns. Is she bothered most about excess hair growth? Does she want to have a baby? Does she need to get her periods back on track? […] There is no boilerplate treatment, says Andrea E. Dunaif, MD, professor of medicine and chief of the Hilda and J. Lester Gabrilove Division of endocrinology, diabetes, and bone disease for the Mount Sinai Health System in New York City. […] One option is taking a medication used to target specific symptoms. It’s important to know that there are no drugs that the U.S. Food and Drug Administration has approved specifically for PCOS, she adds, meaning these options are prescribed off-label. Here are the ones you might talk about with your healthcare team: […] Metformin is among one of the main treatments to target insulin resistance if you have prediabetes or diabetes, including because of PCOS. The advice is controversial, but some physicians believe that PCOS always requires metformin, notes Dr. Dunaif. […] This was originally developed as a blood pressure medication and diuretic for hormonal forms of high blood pressure (hypertension) and fluid retention. Turns out, in high doses, it’s very good at blocking male hormones, explains Dunaif. […] Combination birth control pills those with estrogen and progesterone or progestin are frequently prescribed to women with PCOS not looking to get pregnant. If the main concern is irregular periods and the resulting potential health risks, this is a great option. […] Finasteride, another androgen blocker, is sometimes prescribed to address excess body and facial hair growth in women with PCOS. […] There are very good fertility options for PCOS women that have been well studied with randomized clinical trials, says Dunaif. If a woman wants to become pregnant, her doctor may prescribe oral medication that works very well to induce ovulation, like clomiphene or letrozole.

• #35 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.

• #36 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. Many females worry that these treatments cause hair to grow faster, although this is not true. […] In females with PCOS, hormonal treatment of excess hair growth is typically approached in a two-step process. The first step is to prescribe an estrogen-progestin contraceptive (ie, a birth control pill). If, after six months of hormone treatment, sufficient improvement in excess hair growth has not been achieved, a second medication called spironolactone, an antiandrogen, is added. If hormone treatment with an estrogen-progestin results in a satisfactory reduction in excess hair growth, this therapy is continued.

• #37

  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. […] Letrozole is sometimes used to stimulate ovulation instead of clomifene. […] The combined oral contraceptive pill is usually used to treat excessive hair growth (hirsutism) and hair loss (alopecia). […] A cream called eflornithine can also be used to slow down the growth of unwanted facial hair. […] Medicines can also be used to treat some of the other problems associated with PCOS, including weight-loss medicine, cholesterol-lowering medicine (statins) if you have high levels of cholesterol in your blood, and acne treatments. […] If you have PCOS and medicines do not help you to get pregnant, you may be offered in vitro fertilisation (IVF) treatment.

• #38 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; other useful agents include rosiglitazone and pioglitazone. Metformin can improve menstrual irregularities in patients with PCOS. […] Insulin-sensitizing agents are indicated for most women with PCOS because they have positive effects on insulin resistance, menstrual irregularities, anovulation, hirsutism, and obesity. Of all the drugs used to treat manifestations of PCOS, metformin has the most data supporting its effectiveness. […] Treatments for hirsutism in women with PCOS are similar to those in women without PCOS, such as patients with idiopathic hirsutism. First-line agents include spironolactone and metformin, as well as eflornithine for facial hirsutism. Combination oral contraceptives are among the most commonly used medications for hirsutism in women with PCOS.

• #39 Treatment options for polycystic ovary syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3039006/

  Metformin is a biguanide currently used as an oral antihyperglycemic agent and is approved by the US Food and Drug Administration (FDA) to manage type 2 diabetes mellitus. The use of metformin is associated with increased menstrual cyclicity, improved ovulation, and a reduction in circulating androgen levels. […] Selective aromatase inhibitors such as anastrozole and letrozole are promising new ovulation-inducing agents. They are reversible and highly potent. Glucocorticoids such as prednisone and dexamethasone have been used to induce ovulation. The second possible line of therapy after resistance to CC has been demonstrated in women with PCOS is exogenous gonadotropins. […] In clomiphene-resistant PCOS women who are unable to comply with the close monitoring necessary for gonadotropin administration, bilateral laparoscopic ovarian surgery with monopolar electrocautery (multiple controlled perforation of the ovary) or laser is an acceptable alternative; both modalities confer similar results.

• #40 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.

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

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

  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. […] 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. […] There is limited evidence for the efficacy of anti-obesity drugs, such as orlistat and glucagon-like peptide-1 (GLP-1) receptor agonists (e.g. liraglutide, semaglutide), specifically in women with PCOS, including for reproductive outcomes.

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

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

  Metformin may help a bit with weight loss. Although metformin is not a weight-loss drug, some studies have shown that females with PCOS who are on a low-calorie diet lose slightly more weight when metformin is added. If metformin is used, it is essential that diet and exercise are also part of the recommended regimen because the weight that is lost in the early phase of metformin treatment may be regained over time. […] Metformin is not usually recommended for females with PCOS who have difficulty becoming pregnant, because it is not as effective as other treatments for ovulation induction, letrozole, and clomiphene. […] An expert group does not recommend metformin for females with PCOS in whom excessive hair growth (hirsutism) is of primary concern. Birth control pills alone, or in combination with an antiandrogen medication, are a better option.

• #43

  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. […] Letrozole is sometimes used to stimulate ovulation instead of clomifene. […] The combined oral contraceptive pill is usually used to treat excessive hair growth (hirsutism) and hair loss (alopecia). […] A cream called eflornithine can also be used to slow down the growth of unwanted facial hair. […] Medicines can also be used to treat some of the other problems associated with PCOS, including weight-loss medicine, cholesterol-lowering medicine (statins) if you have high levels of cholesterol in your blood, and acne treatments. […] If you have PCOS and medicines do not help you to get pregnant, you may be offered in vitro fertilisation (IVF) treatment.

• #44 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

  Lifestyle changes and pharmacologic approaches are used to manage insulin insensitivity. […] If obesity is present, weight loss and regular exercise are encouraged. These measures may help induce ovulation, make menstrual cycles more regular, increase insulin sensitivity, and reduce acanthosis nigricans and hirsutism. Weight loss may also help improve fertility. Bariatric surgery may be an option for some women with PCOS. However, weight loss is unlikely to benefit normal-weight women with PCOS. […] Metformin 500 to 1000 mg twice a day is used to help increase insulin sensitivity in women with PCOS, irregular menses, and diabetes or insulin resistance if lifestyle modifications are ineffective or if they cannot take or cannot tolerate hormonal contraceptives. Metformin can also reduce free testosterone levels. When metformin is used, serum glucose should be measured, and kidney and liver function tests should be done periodically. Because metformin may induce ovulation, contraception is needed if pregnancy is not desired. Metformin helps correct metabolic and glycemic abnormalities and makes menstrual cycles more regular, but it has little or no beneficial effect on hirsutism, acne, or infertility.

• #45

  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.

• #46 Treatment options for polycystic ovary syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3039006/

  Metformin is a biguanide currently used as an oral antihyperglycemic agent and is approved by the US Food and Drug Administration (FDA) to manage type 2 diabetes mellitus. The use of metformin is associated with increased menstrual cyclicity, improved ovulation, and a reduction in circulating androgen levels. […] Selective aromatase inhibitors such as anastrozole and letrozole are promising new ovulation-inducing agents. They are reversible and highly potent. Glucocorticoids such as prednisone and dexamethasone have been used to induce ovulation. The second possible line of therapy after resistance to CC has been demonstrated in women with PCOS is exogenous gonadotropins. […] In clomiphene-resistant PCOS women who are unable to comply with the close monitoring necessary for gonadotropin administration, bilateral laparoscopic ovarian surgery with monopolar electrocautery (multiple controlled perforation of the ovary) or laser is an acceptable alternative; both modalities confer similar results.

• #47 PCOS Treatment & Services – UChicago Medicine

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

  New evidence suggests that using medications that lower insulin levels in the blood may be effective in restoring menstruation and reducing some of the health risks associated with PCOS. Lowering insulin levels also helps to reduce the production of testosterone, thus diminishing many of the symptoms associated with excess testosterone: hair growth on the body, alopecia (scalp hair loss), acne and possibly cardiovascular risk. […] Pioglitazone (Actos) and Rosiglitazone (Avandia) are insulin-sensitizing agents that improve glucose tolerance and insulin resistance. These drugs are approved by the Food and Drug Administration (FDA) for the treatment of diabetes. Although they are not approved for treatment of PCOS, they have been shown to be effective for this purpose in many studies. […] Metformin (Glucophage) is an insulin-lowering drug. It is approved by the FDA as a treatment for diabetes, but is not yet FDA-approved for use in treating PCOS. In clinical trials, metformin has been shown to be very effective in restoring menstrual cycles in many, but not all, patients with PCOS.

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

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

  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. […] 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. […] There is limited evidence for the efficacy of anti-obesity drugs, such as orlistat and glucagon-like peptide-1 (GLP-1) receptor agonists (e.g. liraglutide, semaglutide), specifically in women with PCOS, including for reproductive outcomes.

• #49

  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.

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

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

  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. […] 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. […] There is limited evidence for the efficacy of anti-obesity drugs, such as orlistat and glucagon-like peptide-1 (GLP-1) receptor agonists (e.g. liraglutide, semaglutide), specifically in women with PCOS, including for reproductive outcomes.

• #51 Diagnosing and treating PCOS | Jean Hailes

  https://www.jeanhailes.org.au/health-a-z/polycystic-ovary-syndrome/diagnosing-and-treating-pcos

  Research studies have shown that a weight reduction of 5% to 10% can: reduce insulin resistance by about 50%, restore ovulation, regulate menstrual cycles, improve fertility, reduce pregnancy complications, improve the health of mother and child during pregnancy, improve emotional health (self-esteem, anxiety, depression), reduce the risk of developing diabetes and heart disease. […] Symptoms of PCOS, such as excess hair growth and acne, can make you feel self-conscious, reduce your self-esteem and affect your body image and mood. […] More than 70% of women with PCOS in Australia use natural therapies to improve their symptoms and general wellbeing. […] Some studies found that inositol supplements may be effective for regulating menstrual cycles in people with PCOS. […] High levels of androgens can cause excess hair growth on the face and body, and severe acne (pimples). […] Low doses of vitamin D in women with a vitamin D deficiency may improve glucose metabolism and improve total cholesterol, LDL (bad) cholesterol and triglycerides in people with PCOS.

• #52 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/

  Metformin is recommended primarily for metabolic features and has greater efficacy than inositol, which offers limited clinical benefits in PCOS. […] 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.

• #53 Treatment options for polycystic ovary syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3039006/

  Metformin is a biguanide currently used as an oral antihyperglycemic agent and is approved by the US Food and Drug Administration (FDA) to manage type 2 diabetes mellitus. The use of metformin is associated with increased menstrual cyclicity, improved ovulation, and a reduction in circulating androgen levels. […] Selective aromatase inhibitors such as anastrozole and letrozole are promising new ovulation-inducing agents. They are reversible and highly potent. Glucocorticoids such as prednisone and dexamethasone have been used to induce ovulation. The second possible line of therapy after resistance to CC has been demonstrated in women with PCOS is exogenous gonadotropins. […] In clomiphene-resistant PCOS women who are unable to comply with the close monitoring necessary for gonadotropin administration, bilateral laparoscopic ovarian surgery with monopolar electrocautery (multiple controlled perforation of the ovary) or laser is an acceptable alternative; both modalities confer similar results.

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

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

  If you want to become pregnant now or in the future, treatment for PCOS includes: Drugs to induce ovulation (releasing an egg): A successful pregnancy begins with ovulation. Certain drugs have been proven to induce ovulation in people with PCOS. The medications clomiphene and letrozole are taken orally, while gonadotropins are given by injection. […] While there isnt a cure for PCOS, your healthcare provider can help you manage your symptoms. […] Your healthcare provider will work with you to develop a treatment plan to help you ovulate. Your treatment plan could include medication or assisted reproductive technologies like in vitro fertilization (IVF). […] Talk to your healthcare provider about your symptoms if you suspect you have PCOS. Lifestyle changes and medical treatments can help you manage the symptoms, lower your risk of other health conditions and help you get pregnant (if pregnancy is your goal).

• #55 Polycystic Ovary Syndrome: Common Questions and Answers | AAFP

  https://www.aafp.org/pubs/afp/issues/2023/0300/polycystic-ovary-syndrome.html

  Hormonal contraception (e.g., oral contraceptives) should be used as the initial treatment for menstrual cycle irregularity, hirsutism, and acne in patients with PCOS who do not want to become pregnant. […] Letrozole is the first-line drug therapy for patients with PCOS seeking ovulation induction. […] Metformin is the first-line drug therapy for metabolic manifestations of PCOS such as insulin resistance, although it is likely inferior to lifestyle modification, especially for prevention of diabetes. […] Oral contraceptives are first-line drug therapy for oligomenorrhea. […] Oral contraceptives are first-line drug therapy for hirsutism, acne, and androgen-related alopecia, with similar effectiveness among various preparations. Antiandrogens such as spironolactone are second-line drug therapy for hirsutism and acne but should not be used without contraception because it can cause undervirilization in a male fetus. […] Letrozole is preferred over clomiphene for ovulation induction.

• #56 Polycystic ovary syndrome – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/polycystic-ovary-syndrome/

  Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women. Management consists of lifestyle modifications combined with specific treatment, which is tailored to the patient’s reproductive goals. In women who do not wish to conceive, combined oral contraceptive pills are indicated to regulate menses and treat hyperandrogenism. For women who wish to conceive, the goal of treatment is to induce ovulation (e.g., with letrozole). […] For patients who do not wish to conceive, the therapeutic goals are to control menstrual irregularities and hyperandrogenism, treat comorbidities, and improve quality of life. Combined oral contraceptives (COCs) are the first-line treatment for hyperandrogenism and/or menstrual cycle abnormalities. Metformin improves menstrual irregularities, metabolic outcomes, and weight (especially when combined with lifestyle modifications). Letrozole is the first-line therapy for ovulation induction. Clomiphene is an alternative to letrozole. Exogenous gonadotropins are the second-line treatment for ovulation induction. Metformin can be used as second-line monotherapy for fertility treatment. Laparoscopic ovarian drilling is a second-line treatment for ovulation induction. In vitro fertilization can be offered as third-line therapy.

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

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

  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.

• #58 Treatment options for polycystic ovary syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3039006/

  Management of women with PCOS depends on the symptoms. These could be ovulatory dysfunction-related infertility, menstrual disorders, or androgen-related symptoms. Weight loss improves the endocrine profile and increases the likelihood of ovulation and pregnancy. Normalization of the menstrual cycles and ovulation could occur with modest weight loss as little as 5% of the initial weight. The treatment of obesity includes modifications in lifestyle (diet and exercise) and medical and surgical treatment. […] In PCOS, anovulation relates to low FSH concentrations and the arrest of antral follicle growth in the final stages of maturation. Medications and other options available for the induction of ovulation are reviewed in the following sections. CC constitutes one of the first-line treatments for ovulation induction in these patients, as it is economical, is straightforward, has few adverse effects, and requires little monitoring. CC is an estrogen receptor antagonist that interferes with negative feedback of the estrogen-signaling pathway, resulting in increased availability of FSH. Increased FSH leads to follicular growth, followed by an LH surge and ovulation.

• #59 Polycystic Ovary Syndrome | Condition | UT Southwestern Medical Center

  https://utswmed.org/conditions-treatments/polycystic-ovary-syndrome/

  Our specialists prescribe medications based on the specific PCOS symptoms that each patient has, such as: […] Hormonal contraceptives: A combination of birth control pills, skin patches, or vaginal rings that contain estrogen and progestin, which reduce androgen production and regulate menstrual cycles. Hormonal contraceptives reduce abnormal menstrual bleeding, hair growth, and acne. […] Clomiphene citrate (Clomid) or letrozole (Femara): These medications stimulate the ovaries to release eggs and help improve the chance of pregnancy. […] Metformin (Glucophage): This oral medication for borderline and Type 2 diabetes can help regulate periods and stimulate ovulation in about 25 percent of patients. […] PCOS is one of the most common causes of female infertility. At UT Southwestern, our specialists in fertility and reproductive medicine offer a wide range of therapies to help women achieve successful pregnancy.

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

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

  Depilatories: These over-the-counter creams, gels, and lotions break down the protein structure of hair so it falls out of the skin. Follow the directions on the package. […] Getting pregnant with 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. […] Medicines to help you ovulate […] 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.

• #61 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

  Insulin sensitizers (eg, glucagon-like peptide-1 receptor agonists or thiazolidinediones) combined with metformin are being studied. […] Many patients with PCOS have infertility, and those who desire pregnancy should be referred to infertility specialists. Infertility treatments (eg, clomiphene) are used. Clomiphene is currently the first-line therapy for infertility. Weight loss may also be helpful. Hormone therapy that may have contraceptive effects is avoided. The aromatase inhibitor letrozole can also be used to stimulate ovulation. Other fertility medications may also be tried. They include follicle-stimulating hormone (FSH) to stimulate the ovaries, a gonadotropin-releasing hormone (GnRH) agonist to stimulate the release of FSH, and human chorionic gonadotropin (hCG) to trigger ovulation.

• #62

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

• #63

• #64 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. Ovarian drilling involves using electrocautery or a laser to drill holes in small areas of the ovaries that produce androgens. Ovarian wedge resection is not recommended. […] Because women with PCOS-associated obesity have a higher risk of pregnancy complications (including gestational diabetes, preterm delivery, and preeclampsia), preconception assessment of body mass index, blood pressure, and oral glucose tolerance is recommended. […] For hirsutism, physical measures (eg, bleaching, electrolysis, plucking, waxing, depilation) can be used. Eflornithine cream 13.9% twice a day may help remove unwanted facial hair.

• #65 Treatment options for polycystic ovary syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3039006/

  The last possibility for achieving a full-term pregnancy in women with PCOS is to use in vitro fertilization (IVF) techniques. IVF is the first choice in cases of concomitant diseases both in women (severe endometriosis, tubal obstruction, etc) and men (azoospermia, male factor) that reduce the effectiveness of other techniques. […] Chronic anovulation is associated with an increased risk of endometrial hyperplasia and carcinoma. Thus, it is prudent to consider endometrial biopsy in patients with PCOS who have not had menstrual bleeding for a year or longer. […] The over-riding androgenic symptoms that the individual presents will vary from patient to patient; for some it is mainly hirsutism, but for others it is acne and/or alopecia. Many have both hirsutism and acne, and a few complain of significant acne, hirsutism, and alopecia.

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

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

  If a female does not ovulate or is unable to conceive with letrozole or clomiphene, gonadotropin therapy (follicle-stimulating hormone [FSH] injections) is sometimes recommended. However, this treatment can cause multiple pregnancies, including triplets and quadruplets, particularly in patients with PCOS. In modern practice, IVF will often be suggested rather than FSH injections if clomiphene and letrozole do not result in a pregnancy. The risk of multiple gestations is lower with single-embryo transfer IVF cycles when compared with FSH injections.

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

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

  If a female does not ovulate or is unable to conceive with letrozole or clomiphene, gonadotropin therapy (follicle-stimulating hormone [FSH] injections) is sometimes recommended. However, this treatment can cause multiple pregnancies, including triplets and quadruplets, particularly in patients with PCOS. In modern practice, IVF will often be suggested rather than FSH injections if clomiphene and letrozole do not result in a pregnancy. The risk of multiple gestations is lower with single-embryo transfer IVF cycles when compared with FSH injections.

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

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

  Weight reduction decreases androgen production in women who are obese; therefore, losing weight can slow hair growth. […] Women who do not wish to become pregnant can be effectively treated for hirsutism with oral contraceptives. […] Antiandrogens, such as spironolactone, are effective for hirsutism. […] Metformin, an antidiabetic drug, improves insulin resistance and decreases hyperinsulinemia in patients with PCOS. […] Surgical management of polycystic ovarian syndrome (PCOS) is aimed mainly at restoring ovulation. […] Various laparoscopic methods, including electrocautery, laser drilling, and multiple biopsy, have been used with the goal of creating focal areas of damage in the ovarian cortex and stroma. […] Polycystic ovarian syndrome (PCOS) is a disease with many long-term complications. Patients need regular follow-up with their physicians for early detection and management of any untoward sequelae associated with the syndrome.

• #69 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. Ovarian drilling involves using electrocautery or a laser to drill holes in small areas of the ovaries that produce androgens. Ovarian wedge resection is not recommended. […] Because women with PCOS-associated obesity have a higher risk of pregnancy complications (including gestational diabetes, preterm delivery, and preeclampsia), preconception assessment of body mass index, blood pressure, and oral glucose tolerance is recommended. […] For hirsutism, physical measures (eg, bleaching, electrolysis, plucking, waxing, depilation) can be used. Eflornithine cream 13.9% twice a day may help remove unwanted facial hair.

• #70 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; other useful agents include rosiglitazone and pioglitazone. Metformin can improve menstrual irregularities in patients with PCOS. […] Insulin-sensitizing agents are indicated for most women with PCOS because they have positive effects on insulin resistance, menstrual irregularities, anovulation, hirsutism, and obesity. Of all the drugs used to treat manifestations of PCOS, metformin has the most data supporting its effectiveness. […] Treatments for hirsutism in women with PCOS are similar to those in women without PCOS, such as patients with idiopathic hirsutism. First-line agents include spironolactone and metformin, as well as eflornithine for facial hirsutism. Combination oral contraceptives are among the most commonly used medications for hirsutism in women with PCOS.

• #71 Polycystic Ovary Syndrome: Common Questions and Answers | AAFP

  https://www.aafp.org/pubs/afp/issues/2023/0300/polycystic-ovary-syndrome.html

  Hormonal contraception (e.g., oral contraceptives) should be used as the initial treatment for menstrual cycle irregularity, hirsutism, and acne in patients with PCOS who do not want to become pregnant. […] Letrozole is the first-line drug therapy for patients with PCOS seeking ovulation induction. […] Metformin is the first-line drug therapy for metabolic manifestations of PCOS such as insulin resistance, although it is likely inferior to lifestyle modification, especially for prevention of diabetes. […] Oral contraceptives are first-line drug therapy for oligomenorrhea. […] Oral contraceptives are first-line drug therapy for hirsutism, acne, and androgen-related alopecia, with similar effectiveness among various preparations. Antiandrogens such as spironolactone are second-line drug therapy for hirsutism and acne but should not be used without contraception because it can cause undervirilization in a male fetus. […] Letrozole is preferred over clomiphene for ovulation induction.

• #72 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

  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.

• #73 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. Many females worry that these treatments cause hair to grow faster, although this is not true. […] In females with PCOS, hormonal treatment of excess hair growth is typically approached in a two-step process. The first step is to prescribe an estrogen-progestin contraceptive (ie, a birth control pill). If, after six months of hormone treatment, sufficient improvement in excess hair growth has not been achieved, a second medication called spironolactone, an antiandrogen, is added. If hormone treatment with an estrogen-progestin results in a satisfactory reduction in excess hair growth, this therapy is continued.

• #74 PCOS Treatment & Services – UChicago Medicine

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

  Many non-medical approaches can relieve or reduce specific symptoms. These include: […] Weight loss achieved through dietary changes and exercise can help women with PCOS in several ways. Like men and women without PCOS, losing weight reduces a person’s risk of cardiovascular disease and non-insulin dependent (type 2) diabetes. Weight loss also helps to lower the level of insulin in the body which, in turn, reduces the ovaries’ production of testosterone. […] 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.

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

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

  Insulin-sensitizing medications. Metformin, a drug used to treat type 2 diabetes, helps lower insulin and androgen levels. While it’s not FDA-approved to treat PCOS, it can help with ovulation and period problems. […] Androgen blockers. These drugs block the effects of the extra male hormones that cause issues such as unwanted hair growth and acne. But don’t take them if you’re pregnant or plan to get pregnant, because they can cause birth defects. While you’re on them, you should use two different types of birth control. […] Acne medications […] If you have acne that bothers you, a dermatologist can prescribe creams and/or pills to treat and prevent breakouts. […] Excessive hair growth […] If you want to reduce facial or body hair, other options include: […] Electrolysis or laser therapy: Electrolysis removes individual hairs with an electric current that destroys the root. Laser therapy destroys hair follicles. You’ll need several sessions. While some hair may come back, it should be finer and less noticeable.

• #76 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. Many females worry that these treatments cause hair to grow faster, although this is not true. […] In females with PCOS, hormonal treatment of excess hair growth is typically approached in a two-step process. The first step is to prescribe an estrogen-progestin contraceptive (ie, a birth control pill). If, after six months of hormone treatment, sufficient improvement in excess hair growth has not been achieved, a second medication called spironolactone, an antiandrogen, is added. If hormone treatment with an estrogen-progestin results in a satisfactory reduction in excess hair growth, this therapy is continued.

• #77 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

  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. Cyproterone, an antiandrogen (not available in the US), reduces the amount of unwanted body hair in 50 to 75% of affected women. Weight reduction decreases androgen production in women with obesity and thus may slow hair growth. […] GnRH agonists and antagonists are being studied as treatment for unwanted body hair. Both types of medications inhibit the production of sex hormones by the ovaries. But both can cause bone loss and lead to osteoporosis. […] 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.

• #78 Polycystic Ovary Syndrome | Center for Women’s Health | OHSU

  https://www.ohsu.edu/womens-health/polycystic-ovary-syndrome

  Obesity is commonly associated with PCOS. Weight loss improves the hormonal condition of many PCOS patients. If you are overweight, ask your doctor to recommend a weight control plan or clinic. Area hospitals and support groups are also helpful. Increasing physical activity is an important step in any weight reduction program. […] Hormonal treatment is frequently successful in temporarily correcting the problems associated with PCOS. If treatment is stopped, however, symptoms usually reappear. If you are not trying to conceive, birth control pills may be your best hormonal treatment. Birth control pills decrease ovarian hormone production and help reverse the effects of excessive androgen levels. However, birth control pills are not recommended if you smoke and are over age 35. If you also have hirsutism, your doctor may prescribe spironolactone, combined with birth control pills. […] If you are not concerned with fertility or contraception, and hirsutism is not a problem, there is a good treatment option. You can take progesterone at regular intervals to regulate your menstrual cycles and prevent the endometrial problems associated with excessive estrogen exposure.

• #79 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.

• #80 Polycystic ovary syndrome (PCOS): Causes, Symptoms & Treatment | UW MedicineStethascope

  https://www.uwmedicine.org/conditions-symptoms/reproductive-sex-organs/pcos

  If you don’t plan to become pregnant, your treatment may include: Birth control pills. These help to control menstrual cycles, lower androgen levels, and reduce acne. Diabetes medicine. This is often used to lower insulin resistance in PCOS. It may also help reduce androgen levels, slow hair growth, and help you ovulate more regularly. A change in diet and activity. A healthy diet and more physical activity can help you lose weight and reduce your symptoms. They can also help your body use insulin more efficiently, lower blood glucose levels, and may help you ovulate. Medicines to treat other symptoms. Some medicines can help reduce hair growth or acne.

• #81 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

  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. Cyproterone, an antiandrogen (not available in the US), reduces the amount of unwanted body hair in 50 to 75% of affected women. Weight reduction decreases androgen production in women with obesity and thus may slow hair growth. […] GnRH agonists and antagonists are being studied as treatment for unwanted body hair. Both types of medications inhibit the production of sex hormones by the ovaries. But both can cause bone loss and lead to osteoporosis. […] 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.

• #82 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

  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. Cyproterone, an antiandrogen (not available in the US), reduces the amount of unwanted body hair in 50 to 75% of affected women. Weight reduction decreases androgen production in women with obesity and thus may slow hair growth. […] GnRH agonists and antagonists are being studied as treatment for unwanted body hair. Both types of medications inhibit the production of sex hormones by the ovaries. But both can cause bone loss and lead to osteoporosis. […] 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.

• #83 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

  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.

• #84 Polycystic ovary syndrome

  https://dermnetnz.org/topics/polycystic-ovary-syndrome

  Antiandrogenic oral contraceptives (birth control pills) help control acne and hirsutism. They also improve menstrual irregularities. They may be unsuitable for overweight or obese women. […] Spironolactone, a powerful antiandrogen, can reduce acne and also body hair growth over time. It is less effective for alopecia. It cannot be used by women who are trying to conceive as it can cause birth defects. […] Low dose glucocorticoids taken at night are suitable for some women. […] Gonadotrophin releasing hormone agonist medications are under investigation to inhibit pituitary release of LH and thus reduce the secretion of ovarian hormones. […] Isotretinoin is used for severe cases of acne. It cannot be used by women who are pregnant or trying to conceive as it can cause birth defects. PCOS may result in recurrence of acne after initial successful clearance with isotretinoin. […] Hair removal measures such as shaving, electrolysis, chemical and waxing creams can be used to treat hirsutism.

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

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

  Scalp hair loss can be treated with medications in some situations. Other options include hair replacement and wigs. […] 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. For example, many overweight females with PCOS who lose 5 to 10 percent of their body weight notice that their periods become more regular. Weight loss can often be achieved with a program of diet and exercise. […] There are a number of options available to treat obesity. These options are identical to those recommended for females without PCOS and include diet and exercise, weight loss medications (although their use is limited), and weight loss surgery.

• #86 Polycystic Ovary Syndrome: Common Questions and Answers | AAFP

  https://www.aafp.org/pubs/afp/issues/2023/0300/polycystic-ovary-syndrome.html

  Hormonal contraception (e.g., oral contraceptives) should be used as the initial treatment for menstrual cycle irregularity, hirsutism, and acne in patients with PCOS who do not want to become pregnant. […] Letrozole is the first-line drug therapy for patients with PCOS seeking ovulation induction. […] Metformin is the first-line drug therapy for metabolic manifestations of PCOS such as insulin resistance, although it is likely inferior to lifestyle modification, especially for prevention of diabetes. […] Oral contraceptives are first-line drug therapy for oligomenorrhea. […] Oral contraceptives are first-line drug therapy for hirsutism, acne, and androgen-related alopecia, with similar effectiveness among various preparations. Antiandrogens such as spironolactone are second-line drug therapy for hirsutism and acne but should not be used without contraception because it can cause undervirilization in a male fetus. […] Letrozole is preferred over clomiphene for ovulation induction.

• #87 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. […] Adolescents and women who have PCOS and overweight or obesity should be screened for symptoms of obstructive sleep apnea using polysomnography and 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: […] A family history of early-onset cardiovascular disorders […] Cigarette smoking […] Diabetes mellitus […] Hypertension […] Dyslipidemia

• #88 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

  Sleep apnea […] Abdominal obesity (as for metabolic syndrome) […] Clinicians should evaluate cardiovascular risk by determining body mass index (BMI), measuring fasting lipid and lipoprotein levels, and identifying risk factors for metabolic syndrome. […] Adult women with PCOS are evaluated for metabolic syndrome by measuring blood pressure and usually serum glucose and lipids (lipid profile). […] Tests for coronary artery calcification and thickened carotid intima media should be done to check for subclinical atherosclerosis. […] Women with abnormal vaginal bleeding should be screened for endometrial hyperplasia or carcinoma using endometrial biopsy and/or transvaginal ultrasonography or office hysteroscopy.

• #89 PCOS Treatment & Services – UChicago Medicine

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

  Oral contraceptives (birth control pills) contain a combination of hormones (estrogen and progesterone). Used properly, oral contraceptives can ensure that women with PCOS menstruate every four weeks. This, in turn, lowers the risk of endometrial cancer, which is higher in women with PCOS because they do not menstruate regularly and properly shed the endometrial lining. […] Anti-androgenic agents, such as spironolactone, block the effect of androgens (male hormones, including testosterone). In high doses, anti-androgens can reduce unwanted hair growth and acne. […] Many assisted-reproduction techniques are available for women who have difficulty conceiving because of PCOS. Working with UChicago Medicine experts in reproductive endocrinology, the Center for Polycystic Ovary Syndrome offers a full spectrum of standard and innovative fertility therapies from oral and injectible medications that stimulate ovulation to advanced in vitro fertilization techniques, including use of donor eggs.

• #90 Polycystic Ovary Syndrome | Cedars-Sinai

  https://www.cedars-sinai.org/health-library/diseases-and-conditions/p/polycystic-ovary-syndrome.html

  Since there is no specific cure for PCOS, treatment focuses on managing PCOS symptoms and preventing long-term complications. […] Some therapies may include: […] Drug therapy – Including birth control pills to correct irregular menstrual cycles, insulin-sensitizing medications, fertility medications, weight loss pills and acne medications. […] Cosmetic therapy – which can include treatments for hair removal and for clearing up acne. […] Hormone replacement therapy may be prescribed to correct the hormone imbalance associated with PCOS. […] Nutritional counseling is available to treat obesity and help alleviate insulin resistance. […] Surgery to remove the ovaries or uterus (bilateral salpingo-oophorectomy or hysterectomy) is an option for women with severely symptomatic PCOS who do not want future pregnancies.

• #91 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. […] Adolescents and women who have PCOS and overweight or obesity should be screened for symptoms of obstructive sleep apnea using polysomnography and 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: […] A family history of early-onset cardiovascular disorders […] Cigarette smoking […] Diabetes mellitus […] Hypertension […] Dyslipidemia

• #92 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

  Sleep apnea […] Abdominal obesity (as for metabolic syndrome) […] Clinicians should evaluate cardiovascular risk by determining body mass index (BMI), measuring fasting lipid and lipoprotein levels, and identifying risk factors for metabolic syndrome. […] Adult women with PCOS are evaluated for metabolic syndrome by measuring blood pressure and usually serum glucose and lipids (lipid profile). […] Tests for coronary artery calcification and thickened carotid intima media should be done to check for subclinical atherosclerosis. […] Women with abnormal vaginal bleeding should be screened for endometrial hyperplasia or carcinoma using endometrial biopsy and/or transvaginal ultrasonography or office hysteroscopy.

• #93 Natural Treatment PCOS: 30 Ways to Help Hormones, Insulin, and More

  https://www.healthline.com/health/womens-health/natural-treatment-pcos

  While PCOS cannot be cured permanently, treatment along with certain supplements, practices, and dietary changes may help you manage it. […] You may be able to manage these factors and ease your symptoms through lifestyle changes and dietary supplements, but there’s no one-size-fits-all approach to treatment. […] You should always talk with your doctor before you try any alternative treatment. They can discuss possible dosage, side effects, and interactions. […] Supplements claim to help with hormone regulation, insulin resistance, and inflammation associated with PCOS. […] Speak to your doctor before taking any supplement. Some of them can actually interfere with other prescribed PCOS treatments and medications. […] Maintaining a healthy weight can help decrease insulin resistance, regulate your period, and reduce your risk of conditions associated with PCOS.

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

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

  Avoid food from cans lined with BPA […] Wash your hands often, especially before you eat […] Use a vacuum with a HEPA filter […] Alternative Medicine for PCOS […] While no alternative treatments have been proven to help with PCOS symptoms, a few studies have found evidence that some might have benefits. […] Herbs and supplements […] A 2014 review of 33 studies found some evidence that these herbal medicines might help with PCOS symptoms: […] Chaste tree berry […] Black cohosh […] Cinnamon […] Tribulus terrestris, a plant used in Eastern medicine […] Licorice plant […] Licorice plant combined with Chinese peony […] The findings were strongest for chaste tree berry and black cohosh. But the researchers noted that we need more and better research into these possible benefits.

• #95 Natural Treatment PCOS: 30 Ways to Help Hormones, Insulin, and More

  https://www.healthline.com/health/womens-health/natural-treatment-pcos

  If you’re overweight, some studies suggest gradual weight loss through a low-calorie diet as a promising first-line treatment for PCOS. […] Exercise is important for maintaining a healthy weight. But too much exercise can disrupt your hormones, so talk with your doctor about a healthy balance. […] Talk with your doctor about the type of workout that would benefit you most. […] There’s enough research to make a case for acupuncture as an alternative treatment for PCOS. […] Acupuncture may help PCOS by increasing blood flow to your ovaries, reducing cortisol levels, helping with weight loss, and improving your sensitivity to insulin. […] You should always check with your doctor before starting any alternative therapy. Some treatments that claim to be miracle products for PCOS can actually impact your fertility or lead to other complications. […] If you’re considering any of the above natural treatment options for PCOS, work with your doctor to make a treatment plan.

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

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

  Spearmint tea for PCOS […] Some studies have found that regularly drinking tea made from spearmint leaves could help balance hormone levels in those with PCOS. It may also reduce the growth of excess facial and body hair. The tea is caffeine-free, so you might try drinking 2-3 cups a day to see if it helps with your symptoms. But talk to your doctor first, especially if you’re pregnant, trying to get pregnant, or have other health conditions. […] Acupuncture for PCOS […] Acupuncture is a type of complementary medicine in which a practitioner inserts thin needles into specific points on your body. Some studies have found it may help regulate hormones and ovulation and reduce insulin resistance in those with PCOS. But other researchers say there’s not yet enough good evidence that it works as a treatment for PCOS.

• #97 Natural treatments for PCOS: Evidence-based methods

  https://www.medicalnewstoday.com/articles/326560

  Natural treatments and lifestyle changes may help with the symptoms of polycystic ovary syndrome (PCOS). […] While there is no cure for PCOS, several medical treatments, such as the birth control pill, can help manage its symptoms. […] Losing weight through exercise and healthful eating may help a person reduce PCOS symptoms. […] Changing the diet is an essential part of managing PCOS. […] The best diet for someone with PCOS would comprise complex carbs, lots of fruits and vegetables, and lean proteins. […] Exercise is an important component of weight loss. […] Some people use nutritional supplements to help control their PCOS symptoms. […] A 2017 review looked at 24 studies to see whether nutritional supplements were safe, effective ways of managing PCOS. […] The researchers found Vitex agnus-castus and Cimicifuga racemosa to be most effective in managing irregular ovulation and resultant infertility.

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

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

  Avoid food from cans lined with BPA […] Wash your hands often, especially before you eat […] Use a vacuum with a HEPA filter […] Alternative Medicine for PCOS […] While no alternative treatments have been proven to help with PCOS symptoms, a few studies have found evidence that some might have benefits. […] Herbs and supplements […] A 2014 review of 33 studies found some evidence that these herbal medicines might help with PCOS symptoms: […] Chaste tree berry […] Black cohosh […] Cinnamon […] Tribulus terrestris, a plant used in Eastern medicine […] Licorice plant […] Licorice plant combined with Chinese peony […] The findings were strongest for chaste tree berry and black cohosh. But the researchers noted that we need more and better research into these possible benefits.

• #99 Diagnosing and treating PCOS | Jean Hailes

  https://www.jeanhailes.org.au/health-a-z/polycystic-ovary-syndrome/diagnosing-and-treating-pcos

  Research studies have shown that a weight reduction of 5% to 10% can: reduce insulin resistance by about 50%, restore ovulation, regulate menstrual cycles, improve fertility, reduce pregnancy complications, improve the health of mother and child during pregnancy, improve emotional health (self-esteem, anxiety, depression), reduce the risk of developing diabetes and heart disease. […] Symptoms of PCOS, such as excess hair growth and acne, can make you feel self-conscious, reduce your self-esteem and affect your body image and mood. […] More than 70% of women with PCOS in Australia use natural therapies to improve their symptoms and general wellbeing. […] Some studies found that inositol supplements may be effective for regulating menstrual cycles in people with PCOS. […] High levels of androgens can cause excess hair growth on the face and body, and severe acne (pimples). […] Low doses of vitamin D in women with a vitamin D deficiency may improve glucose metabolism and improve total cholesterol, LDL (bad) cholesterol and triglycerides in people with PCOS.

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

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

  Spearmint tea for PCOS […] Some studies have found that regularly drinking tea made from spearmint leaves could help balance hormone levels in those with PCOS. It may also reduce the growth of excess facial and body hair. The tea is caffeine-free, so you might try drinking 2-3 cups a day to see if it helps with your symptoms. But talk to your doctor first, especially if you’re pregnant, trying to get pregnant, or have other health conditions. […] Acupuncture for PCOS […] Acupuncture is a type of complementary medicine in which a practitioner inserts thin needles into specific points on your body. Some studies have found it may help regulate hormones and ovulation and reduce insulin resistance in those with PCOS. But other researchers say there’s not yet enough good evidence that it works as a treatment for PCOS.

• #101 Natural Treatment PCOS: 30 Ways to Help Hormones, Insulin, and More

  https://www.healthline.com/health/womens-health/natural-treatment-pcos

  While PCOS cannot be cured permanently, treatment along with certain supplements, practices, and dietary changes may help you manage it. […] You may be able to manage these factors and ease your symptoms through lifestyle changes and dietary supplements, but there’s no one-size-fits-all approach to treatment. […] You should always talk with your doctor before you try any alternative treatment. They can discuss possible dosage, side effects, and interactions. […] Supplements claim to help with hormone regulation, insulin resistance, and inflammation associated with PCOS. […] Speak to your doctor before taking any supplement. Some of them can actually interfere with other prescribed PCOS treatments and medications. […] Maintaining a healthy weight can help decrease insulin resistance, regulate your period, and reduce your risk of conditions associated with PCOS.

• #102 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.

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

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

  Antiandrogens play a role in managing clinical hyperandrogenism in PCOS via diverse mechanisms. […] Management of PCOS requires a comprehensive patient-centred approach, incorporating education, empowerment and shared decision-making to optimise the patients experience and health outcomes. The International Evidence-based Guideline for the Assessment and Management of PCOS 2023 provides guidance on nonpharmacological and pharmacological management of PCOS. Choice of pharmacotherapy is driven by the individual patients symptoms and may include the COCP, metformin, inositol, anti-obesity drugs and antiandrogens.

• #104 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.

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

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

  Antiandrogens play a role in managing clinical hyperandrogenism in PCOS via diverse mechanisms. […] Management of PCOS requires a comprehensive patient-centred approach, incorporating education, empowerment and shared decision-making to optimise the patients experience and health outcomes. The International Evidence-based Guideline for the Assessment and Management of PCOS 2023 provides guidance on nonpharmacological and pharmacological management of PCOS. Choice of pharmacotherapy is driven by the individual patients symptoms and may include the COCP, metformin, inositol, anti-obesity drugs and antiandrogens.

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