Treating PCOS When Not Trying to Conceive
What treatments for PCOS symptoms are available?
There are many medications that can be used to control PCOS symptoms, and some may be
used in combination with each other. Among the most common is the birth control pill,
discussed directly below. Other anti-androgens such as spironolactone (Aldactone),
Flutamide, cyproterone acetate, and Finasteride may be used to help control cosmetic
issues. Corticosteroids are sometimes used as well, though their side effects may be
intolerable. Women who are not seeking pregnancy can also make use of a wide variety
of blood pressure and cholesterol lowering medications, in addition to insulin-
sensitizing medications. The best course of action depends on individual needs.
Are birth control pills safe for women and adolescents with PCOS?
Most doctors feel that oral contraceptives are safe for women with PCOS and may even
provide some health benefits. Besides regulating menstruation, birth control pills can
increase sex-hormone binding globulin (SHBG) and thereby reduce circulating androgens.
Different varieties may be more effective at reducing androgen levels and helping to
clear acne.
Adolescents with irregular cycles should have an endocrine evaluation before being put
on the pill.
Some concerns about using the pill include the possibility that it may contribute to
insulin resistance, and that oral contraceptives containing ethinyl estradiol and
norethindrone may not work effectively if taken at the same time as rosiglitazone
maleate (Avandia), or pioglitazone hydrochloride (Actos). Use of birth control pills
is also contraindicated in women who smoke and those who were exposed to
diethylstilbestrol (DES) in utero.
What is the best birth control pill for women PCOS?
There is no one best oral contraceptive for all women with PCOS, but there are lots of
different theories. One concern about the triphasic pills is that the low starting dose
may not be enough to inhibit follicle production, and the small follicles produced can
contribute to the appearance of polycystic ovaries. The monophasic pills may be more
likely to halt follicle production while also reducing androgen levels, but some women
do experience more unpleasant side effects on them.
What other methods may be used to induce a period?
Women who do not wish to take oral contraceptives may induce menses by taking progestins
such as Provera, Aygestin, and Cycrin for 5-10 days. Insulin-sensitizing medications may
also help restore normal cycles.
Can PCOS be treated with herbal supplements?
Herbal supplements are unregulated and how they may react with prescription medications
is unknown. While it is unlikely that the herbs themselves will do much harm, there is a
good chance they won't help either. Anyone who truly wants to medicate with herbs should
see a naturopath rather than self-medicate.
Will removing my ovaries cure my PCOS?
At present, there is no cure for PCOS. The endocrine upset characterized by polycystic
ovaries does not go away just because the ovaries are removed. Attention must be focused
on why the ovary acted that way, and what signals called it to make 30 pellet-sized
follicles at the same instant? It is possible that it might lessen symptoms, but it is a
rather extreme approach that will not prove to be a cure.
Does PCOS get worse over time?
It is possible that PCOS will worsen during the prime reproductive years, ages 20-40,
especially with weight gain. A healthy lifestyle is probably the best defense. It seems as
women approach menopause that the severity of PCOS improves, as judged by hormonal
parameters.
How should PCOS be managed after menopause?
There is very little information in medical journals about PCOS beyond the childbearing
years. Right now the best recommendation is to monitor cholesterol, triglycerides, blood
pressure, and glucose/insulin levels as one might for Syndrome X, and treat any minor
abnormalities with diet and exercise, and more substantial alterations with medication.
