Polycystic ovary syndrome medical therapy
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Differentiating Polycystic ovary syndrome from other Diseases |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
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Overview
Medical Therapy
The first step in the management of PCOS is weight loss if the patient is obese, and treatment of type 2 diabetes, if present, with metformin. In significantly overweight patients, weight loss alone usually effects a cure and should always be vigorously attempted. Diet and exercise are recommended in all women with PCOS. The next step is initiation of treatment to break the self-perpetuating anovulatory cycling, either by stimulating ovulation or suppressing androgenic and ovarian activity. The selection of treatment depends on whether pregnancy is desired. All antiandrogen treatments will take at least 3 months to affect hirsutism. The goals of treatment are:
- Exclude androgen-secreting tumors, endometrial tumors, and endometrial hyperplasia
- Reduce ovarian androgen secretion and/or antagonist activity at target tissues
- Interrupt the self-sustaining abnormal hormonal cycle
- Normalize the endometrium
- Restore fertility by correcting anovulation, if desired
- Reduce insulin resistance