PCOS and Menstruation
Anovulation (not ovulating) can lead to an abnormal overgrowth of the uterine lining (endometrial hyperplasia), which increases the risk of uterine cancer.
Menstrual abnormalities can be treated with medications that might include oral contraceptives to regulate the menstrual cycle.
PCOS and Hormones
The goal of PCOS treatment is to decrease the amount of androgens in the bloodstream, thereby decreasing the clinical effects of androgens on the body (e.g., facial hair growth and acne). The most common treatment is low-dose oral contraceptives. Oral contraceptives decrease androgens in a variety of ways.
For PCOS and facial hair, it is recommended to combine medical treatment with mechanical hair removal methods such as electrolysis, waxing, or laser hair removal.
PCOS and Insulin Resistance
Insulin resistance and hyperinsulinemia (elevated blood insulin levels) are common in women with PCOS. These metabolic abnormalities can lead to impaired glucose tolerance and Type 2diabetes mellitus. Some women achieve positive results by going on the type of diet used for diabetes prevention.
Currently, metformin, an insulin-sensitizing medication, is used for the treatment of patients with PCOS. The goals of treatment include improving insulin resistance and lowering insulin levels. An improvement in ovulatory function can also be obtained.
PCOS and Fertility
Women with PCOS are either oligo ovulatory or anovulatory, meaning that they ovulate less often than normal or not at all. If ovulation does not take place, there is no opportunity for egg-sperm interaction and pregnancy to occur. The goal of treatment for infertility in PCOS is to cause ovulation to occur predictably.
If ovulation or pregnancy is not attained with these more conservative treatments, they can be combined with gonadotropin therapy (FSH or human menopausal gonadotropin - HMG - injections. However, gonadotropin therapy may include side effects such as increased multiple pregnancy rates and ovarian hyperstimulation syndrome (OHSS).