Medical Treatment of (Polycystic Ovary Syndrome) PCOS

PCOS or polycystic ovary syndrome may be a contributing factor to infertility in women. However, not all women diagnosed with PCOS have difficulties becoming pregnant. If you have PCOS and this is linked to failure to conceive, your fertility doctor will recommend a few medication treatments. The medications can reduce the levels of insulin and testosterone and regulate the menses, reducing the other symptoms of PCOS as well.

Understanding PCOS

Polycystic ovary syndrome is an endocrine disorder that may affect up to 10% of women in their reproductive years. The condition will manifest through:

  • Anovulation or inovulation, resulting in irregular or absent menstruation
  • Obesity
  • Acne
  • Hair growth in excess (i.e. on face)

These symptoms are due to the excess of testosterone, which is a masculine sexual hormone. Women with PCOS also produce an increased level of insulin. While not all women with PCOS have a hard time trying to become pregnant, the condition can be considered the culprit in many women with PCOS.

Medication Treatment for PCOS

A fertility doctor can establish if you have PCOS by performing a blood test and abdominal ultrasounds. The first choice of treatment will include some medications that are meant to reduce the levels of insulin and testosterone:

  • Clomiphene citrate, a medication that was introduced in the treatment of PCOS in the mid 1960's
  • Insulin sensitizing medications such as metformin (pending FDA approval) and thiazolidinedione
  • Injectable fertility medications, most frequently gonadotropins. These substances will stimulate the maturation of several ovules at once and may lead to twins or triplets in the case of a successful pregnancy. Gonadotropins may be expensive and are rarely chosen as a course of treatment.

When pregnancy is not desired and you want to eliminate the symptoms, the doctor can prescribe some birth control pills, which will reduce the levels of male hormones.

Effects of Medication for PCOS

The medications prescribed for PCOS may have side effects such as hair loss. However, there will be beneficial effects also:

  • Reduced growth of facial hair
  • Reduced acne
  • Normal levels of insulin
  • Weight loss
  • Regular menstruation and reduced risks of miscarriage

The success rates of medication treatment in women with PCOS is variable and has been found to be between 25% and 80%, with pregnancies resulting as early as 2 months after the medication treatment has been started. Most women will have a regular menses after 6 months of treatment with medications.

Weight loss is also recommended to increase the chances of pregnancy. When combined with weight loss, the medication treatment has proven to be more effective.

Alternative Treatments

If you don’t respond to the medication treatment and ovulation will not become regular, your doctor may recommend ovarian drilling. This is a surgical procedure that will remove some testosterone producing tissues from the ovaries.

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