As of now, there is no complete cure for polycystic ovary syndrome (PCOS). Treatment of PCOS depends upon various factors like severity of symptoms, types of symptoms and morbidities associated with it. Incorporation of a healthy lifestyle in adjunct to medications can help in managing PCOS. Let us learn more about PCOS and the available treatment options.
PCOS is one of the most common endocrinal disorders in a female of reproductive age. This disorder is characterized by hormonal imbalance. Three hormones that are involved in PCOS are androgens (higher levels as compared to normal), insulin (higher levels that trigger androgen formation), and progesterone (decreased levels).
Normally, all the hormones viz. estrogen, progesterone, FSH, LH, and androgens work in sync to maintain a normal menstrual cycle and ovulation (release of a mature egg from the ovary). In PCOS, the egg does not mature enough for ovulation and results in follicles with immature eggs, known as cysts. Multiple cysts formation gives it the name polycystic. Moreover, imbalance of hormones, especially the lower level of progesterone, results in an irregular menstrual cycle.
Insulin is a hormone secreted by the pancreas and is responsible for maintaining glucose levels in the blood. Insulin resistance is a condition commonly associated with PCOS. In this condition, the body cells are resistant to the insulin present and result in increased production of insulin by the pancreas. This causes high serum insulin levels, which is seen to trigger the production of androgens
PCOS Treatment Options
Two types of treatment options are available and are as follows:
1. Lifestyle changes
Obesity is one of the most common features of PCOS and is seen in 61-76% of the females suffering from it. The American Task Force and the PCOS Australian Alliance Guidelines suggests exercise and calorie-restricted diet as a crucial part in managing obesity in females suffering from PCOS. Moreover, lifestyle modification is considered as a cost-effective first line of treatment and an essential adjunct to medications.
Even 5-10% reduction of body weight improves fertility, regulates the menstrual cycle, reduces androgen and insulin levels, and decreases acne. Excessive weight is associated with adverse reproductive health and metabolic outcomes. According to research, the fertility of a female significantly reduces with a BMI of 30-32.
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2. Medical treatment
In the failure of lifestyle changes to improve symptoms of PCOS, medical treatment is recommended along with lifestyle changes for better management of symptoms. The following drugs are used for the treatment of PCOS
- Oral contraceptive (OC) pills: This is the most common choice of long-term treatment of PCOS. It creates hormonal balance by reducing the levels of androgens. OC pills reduce androgen-related symptoms like acne and hirsutism. OC pills also help to regulate the menstrual cycle.
- Metformin: This drug is used to treat type 2 diabetes mellitus. Metformin inhibits the production of glucose by the liver and improves insulin sensitivity, reducing insulin levels and thus the level of androgens.
- Thiazolidinediones: It belongs to the insulin sensitizer group of drugs and is used in the treatment of type 2 diabetes mellitus. Use of this drug is seen to reduce serum insulin levels and improves insulin sensitivity. All this reduces the production of androgens by the body.
- Inositol: This is a comparatively new drug that is an insulin-sensitizing molecule. Myo-inositol (MYO) and D-chiro-inositol (DCI) are 2 isomers of inositol used in the treatment of PCOS.
- Spironolactone: It is a steroidal hormone that improves insulin sensitivity.
PCOS is an endocrinal disorder characterized by hormonal imbalance, irregular periods, and multiple cysts in the ovaries. Though there is no complete cure for PCOS, symptoms can be easily managed by lifestyle medication and medicines.