What to know about PCOS treatment

Effective polycystic ovary syndrome treatments can improve your quality of life — and fertility

Polycystic ovary syndrome (PCOS) can lead to symptoms ranging from weight gain and acne to irregular periods and even infertility. In fact, this hormonal disorder in women can be difficult on self-esteem and lead to serious health concerns, if left untreated.

“PCOS is a very common condition in women of child-bearing age that affects the ovaries,” says Jennifer Gell, MD, an obstetrician/gynecologist and reproductive endocrinologist at Geisinger. “And when the ovaries are affected, so too are your menstruation and fertility.”

Thankfully, there are many effective treatments to manage your physical symptoms and improve your confidence, quality of life and even your ability to have a baby.

PCOS symptoms

Women with PCOS are often overweight and will exhibit at least 2 of these problems:

Not ovulating
High levels of male hormones called androgens
Cysts on 1 or both ovaries

These characteristics can lead to many bothersome PCOS symptoms like:

Irregular menstrual cycles
Excessive hair growth on the face, chest or thighs
Severe acne
Obesity, weight gain or trouble losing weight
Male-pattern baldness
Patches of dark skin, especially on the neck, armpits, groin or under your breasts
Fertility problems due to abnormal ovulation

“Some women may not even realize they have PCOS until they start trying to get pregnant,” says Dr. Gell. “PCOS is a common cause of infertility. Challenges with fertility can arise due to irregular ovulation, making conception more difficult.”

Besides reproductive issues, people with PCOS have an increased risk of chronic conditions like Type 2 diabetes, sleep apnea, high blood pressure and heart disease. Seeking treatment improves not just your health, but your quality of life.

How to treat PCOS

Your symptoms, your health conditions and whether you want to get pregnant all play into your PCOS treatment. It often requires a comprehensive approach, including lifestyle changes, medication or a combination of both.

“PCOS treatment can go a long way toward managing symptoms, reducing the risk of long-term complications and improving chances for pregnancy,” says Dr. Gell. “After PCOS treatment and lifestyle changes, many women are able to conceive naturally.”

PCOS lifestyle modifications

Obesity, which can cause insulin resistance, typically causes more severe PCOS symptoms. So losing excess weight is key to helping manage your symptoms.

Weight loss can lower insulin and androgen levels — which may be enough to restore ovulation and help regulate periods to improve your chances for pregnancy.

“It doesn’t have to be significant weight loss, either, to make an impact,” says Dr. Gell. “Even losing as little as 5% to 10% can positively impact hormonal balance and your physical symptoms — and also reduce your risk for complications like high blood pressure and Type 2 diabetes.”

Of course, following a healthy diet and exercising regularly are key components in weight loss.

You can significantly improve insulin sensitivity by filling your plate with:

Fruits and vegetables
Lean proteins like chicken, turkey and fish
Whole grains
Healthy fats like olive oil, avocado and nuts

“Watch out for a diet high in carbohydrates, though. It can increase insulin levels and exacerbate symptoms,” says Dr. Gell. “Instead, stick to complex carbs that raise your blood sugar more slowly, like sweet potatoes, peas, beans, lentils and whole grains.”

And keep moving. You can lose weight, regulate menstrual cycles and improve insulin activity through aerobic exercises, such as walking, bicycling or swimming. Strength training builds muscle mass and boosts metabolism. A bonus: Exercise is a proven mood-booster and can help stem depression and self-esteem issues driven by PCOS.

PCOS drug therapy

In combination with lifestyle changes, your doctor may also recommend drug therapies (depending on symptoms that are concerning you most):

Hormonal birth control. If you don’t want to get pregnant, hormonal birth control (e.g., pills, patches, IUDs) is a first-line treatment to address distressing symptoms. They regulate your hormones and reduce androgen levels to correct irregular periods, acne and excess hair growth, while reducing your risk of endometrial cancer.
Fertility drugs. If you do want to get pregnant, there are several drug options, such as clomiphene (Clomid^®) and letrozole (Femara^®), to stimulate your ovaries and increase your chances of conceiving.
Insulin-sensitizing medicine. Metformin (Glucophage^®), a drug used to treat Type 2 diabetes, helps your body process insulin more effectively to keep glucose levels stable. It may improve your ability to lose weight, while lowering blood sugar levels and your risk for diabetes, and also can help clear acne, reduce hair growth and improve response to ovulation medications.
Anti-androgens. These drugs can block the effect of androgens to control acne and excess hair growth, and help reduce male-pattern balding. However, they can cause birth defects, so you should only use them with adequate contraception.

“Because some of these PCOS treatments can prevent pregnancy or harm a fetus, talk to your doctor about your fertility goals,” says Dr. Gell. “If you decide to use treatment that affects pregnancy, make sure to use an effective birth control to avoid complications.”

Living with PCOS

While there’s no cure for PCOS, there are effective ways to manage your symptoms to regain control over your health and well-being.

“Eating nutritious foods, exercising regularly and managing a healthy weight are the first steps in coping and helping you avoid the effects of PCOS,” says Dr. Gell. “These lifestyle changes can affect hormone levels and ease distressing symptoms — while also lowering your risk of other serious health conditions.”