How is PCOS treated in women who are not actively trying to become pregnant?
If fertility is not an immediate concern, hormonal therapies can be used to correct many of the associated problems. Oral contraceptive pills (OCPs) can help regulate menstrual periods and improve hirsutism and acne. Additional treatments including both oral and topical medications can be used to reduce hirsutism. Hair removal methods such as laser and electrolysis are also effective. For the risks of cardiovascular disease and diabetes, lifestyle modification including good nutrition and exercise are important. In addition, medications that help increase the body’s sensitivity to insulin, such as metformin, may be used. These may reduce the risk of developing diabetes or metabolic syndrome and may help improve ovulation.
How is infertility in women with PCOS treated?
The main reason why women with PCOS have infertility is because they are not ovulating regularly. Ovulation can be induced with medication and is combined with timed intercourse or intrauterine insemination. One of the oral medications is clomiphene citrate (clomid), which is typically taken for 5 days at the beginning of a cycle. With use of the ultrasound, we can tell when and how well the ovaries respond to the medication. If the ovaries do not respond to clomid, another oral medication called letrozole may be considered. If oral medications do not work, gonadotropins, which are injectable fertility medications, may be used. These are associated with a higher risk of multiple gestation pregnancy and /or overstimulation of the ovaries, therefore these cycles are very closely monitored. If these methods of ovulation induction do not result in pregnancy, in vitro fertilization may be considered and is very effective.
Overall, PCOS should be considered a life-long condition, and the treatment is individualized to the needs of the patient. It is important to approach this condition comprehensively, addressing all of the affected systems.
New York Fertility Services and PCOS
At New York Fertility Services, our goal is to provide comprehensive individualized care for all women with PCOS, including those seeking fertility and those who are not. We have a clinic dedicated entirely to women with PCOS, led by Dr Batzofin, an expert in this condition. He has spent years studying and investigating PCOS, including treating patients with PCOS successfully. He will do a thorough evaluation, including your medical history, physical exam with pelvic ultrasound and blood work. Once the diagnosis has correctly been established, a treatment program tailored to your specific symptoms will be designed, as no two cases are exactly alike. This customized program will include diligent monitoring via regularly scheduled office visits and blood work. If fertility is an immediate concern, this will also be addressed. It is important that a medical specialist help you address this life-long condition.