Medical Approach to Treating PCOS
The treatment of PCOS requires four important goals:
- Lowering of insulin levels
- Restoration of fertility
- Treatment of the woman’s excess hair growth and/or acne
- Restoring regular menstruation, and prevention of endometrial hyperplasia and endometrial cancer
Reduce the Risk of Diabetes and Cardiovascular Disease:
The most important goals here relate to creating a diet which is heart-healthy and anti-diabetes, a low glycemic foods, along with regular exercise.
Foods to Avoid:
- Reduce or eliminate all forms of refined sugar
- Reduce or eliminate all refined (simple) carbohydrates. Follow the Full Spectrum Diet. This says to cut out all white foods, which include all white bread, rice, pasta, low fiber foods, most breakfast cereals and rice cakes.
- Reduce or eliminate-Reduce animal products and fats
- Reduce or eliminate all soda, fruit juice and sugary drinks
- Reduce or eliminate excessive milk and dairy products
- Reduce or eliminate alcohol and caffeine
- Reduce or eliminate fertility diets that suggest you eat large amounts of yams. These are not appropriate for PCOS
- Reduce the intake of oily, fried, and sugary foods, fried snacks and fast foods
- Do not miss meals; and do not starve in terms of total quantity of food
Foods You Should Eat:
- Eat adequate amounts of protein
- Eat as much fresh vegetables as you can
- Eat foods, which nourish the liver such as dark green vegetables, lemons, carrots and beets
- Eat fruit light in sugar and sweetness such as berries
- Eat complex carbohydrates (lower glycemic carbohydrates), which tend to have more fiber such as bran cereal, brown rice, whole wheat, whole-grains and nuts and grains like quinoa, whole oats, and bulgur.
These foods help women with PCOS to maintain steady blood sugar and insulin levels and can assist in weight loss. A diet composed of mainly Low Glycemic Index foods will also help to combat the effects of insulin resistance.
Medications May Be Prescribed:
To control or regularize menstrual periods and fertility
- Steroid hormones: Bioidentical progesterone, estrogens, and corticosteroids, or birth control pills to control periods and reduce excess facial hair and acne.
- Anti-Androgens: Androgen-lowering medications such as- Spironolactone (Aldactone), Cyproterone acetate, Flutamide (Eulexin), Finasteride (Propecia, Proscar)
- Fertility agents: To help the woman become pregnant - Clomiphene citrate (Clomid, Serophene), Gonadotropin injections, hCG (human choriuionic goinadotropin), GnRH Lutrepulse
- Pregnancy: IVF (in-vitro fertilization)
Reduce weight and control Insulin and Prevent Diabetes
- Anti-Obesity medications: Orlistat (Xenical), Sibutramine (Meridia)
- Anti-diabetes medications: Metformin, can help control insulin and blood sugar levels and reduce androgen levels. This lowers your risk for diabetes and heart disease and can help restore regular menstrual cycles and fertility.
Surgical Treatments
- Ovarian wedge resection or drilling, removal of ovaries or total hysterectomy
Regular follow-up is crucial to make sure the treatment program is working and if not adjusted as needed. You may also need regular tests to check for diabetes, high blood pressure, and other possible problems.
Removal of Hair and Treatment of Acne
It may take a while for treatments to help with symptoms such as facial hair or acne. In the meantime:
- Over-the-counter or prescription acne medicines may help with skin problems.
- Waxing, tweezing, and shaving are easy ways to get rid of unwanted hair. Electrolysis or laser treatments can permanently remove the hair but are more expensive. Your doctor can also prescribe a skin cream that slows hair growth for as long as you use it regularly.
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