PCOS: Treatment Options
Treatments for PCOS can help to relieve distinct symptoms, like acne and weight gain. Some treatments help put your body back into balance with the proper amounts of hormones. The following treatment options have helped many women:
Birth control pills (oral contraceptives) that contain female hormones can bring on more regular periods and help treat the problem of irregular menstrual cycles. These contraceptive pills help to lower levels of androgens and can improve acne and hair growth as well.
Insulin-sensitizing medications used to treat adult-onset diabetes are useful for many women with PCOS. These medications are not FDA-approved for the treatment of PCOS. By lowering insulin levels, they may improve the regularity of menstrual. Metformin is the drug of choice, but doctors should prescribe the drug with caution. There is not yet enough information to recommend this drug for all women with PCOS. (Another similar acting drug, troglitazone, was removed from the market because of liver damage in patients who had diabetes). Ask your doctor about metformin. It may be helpful in some women to induce ovulation and may play a role in preventing early pregnancy loss. It has been used during pregnancy but there is no consensus on this use at present.
Ovulation Induction. In some women who wish to become pregnant, inducing ovulation (release of an egg) is necessary. This is usually accomplished by taking a pill called clomiphene citrate for five days. Other treatments include the injection of the brain hormone GnRH or gonadotropins. Other infertility treatments include additional medications and even surgery to induce ovulation. High-tech treatments include in vitro fertilization, in which an egg fertilized with sperm is implanted in the uterus.
Androgen-lowering drugs can be used to treat several PCOS symptoms. Spironolactone and flutamide can help to relieve the symptoms of excessive or thinning hair and acne. They can be taken along with oral contraceptives.
An anti-hair-growth drug also can help to slow the growth of facial hair in women with PCOS. The drug is not a depilatory that loosens and gets ride of hair. Eflornithine hydrochloride, the active ingredient, blocks an enzyme found in the hair follicle of the skin that is needed for hair growth. This results in slower hair growth after a few weeks of treatment.
Other treatments for excess hair include bleaching and shaving your excess hair, which are safe and easy approaches. Waxing, tweezing, depilatory creams, and electrolysis and laser treatments to remove hair may also be effective treatments for excess hair.
Treatments for hair loss tend not to work for everyone. Some women find improvements with the use of anti-androgen pills, and others find that the same medication that men use (Rogaine) can help too.
Sticking to a special diet is a very important aspect of PCOS care. Some women with PCOS find success by reducing their total intake of carbohydrates (cereals, breads, pastas) and choosing to eat different types of carbohydrates that are less processed (whole wheat, brown rice, beans). Replacing manufactured carbohydrate products with whole grains, fruits and vegetables can help to reduce your insulin response. The diet also should include enough protein to control the amount of sugar in the blood.
Exercise also can help the body use insulin better, and help with weight loss and keeping off weight.
Acne treatments sold over the counter can also help to control the skin blemishes that can arrive with PCOS.
To treat skin problems other than acne, ask your doctor. Your doctor or dermatologist can remove skin tags using just a simple anesthetic on your skin. Acanthosis nigricans (skin darkening) sometimes can be lightened by reducing your insulin level. Other treatments include Retin-A, 15% urea, alpha hydroxy acid, and salicylic acid.
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