Polycystic Ovary Syndrome (PCOS) is a hormone disorder that can affect women throughout their reproductive years. Menstrual cycles can become irregular, and you can become less fertile. The body also overproduces male androgen hormones, leading to excessive hair growth, acne, and weight gain. In addition, women with PCOS face a higher risk of developing type 2 diabetes and heart disease. There is no cure for PCOS, but there are many treatments that can be used to greatly improve symptoms.
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Part 1 of 2: Lifestyle Change
Step 1. Lose weight
Weight management is important for women with PCOS. There's no need to lose weight if your Body Mass Index (BMI) is rated "normal" or "healthy," but if you're overweight, even a small amount of weight loss can help balance your hormones.
- Losing as little as 5-7 percent of body weight in just six months can dramatically reduce the high androgen levels caused by PCOS. For more than 75 percent of women, the effect is large enough to restore ovulation and fertility.
- Insulin resistance is another major component of PCOS, and obesity can exacerbate insulin resistance.
- You don't have to try any popular diet or intense exercise to lose weight. Oftentimes, keeping an eye on the total calorie count is enough to produce results. Eating no more than 1,200-1,600 calories daily on average is usually enough to help you lose weight.
Step 2. Improve your eating habits
Eat a more balanced diet consisting of lots of fruits, vegetables, whole grains, and low-fat dairy products. You should also consider making changes to your diet that can help keep your blood sugar levels normal.
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Because PCOS is associated with insulin resistance, keeping blood sugar and insulin levels stable can be very important. Follow a low-carb diet, eating only complex carbohydrates rich in dietary fiber.
- Eat high-quality carbohydrates in moderation-vegetables, fruits, and whole grains-and avoid low-quality carbohydrates-sugar foods, white/ground cereals, fruit juices and baked goods.
- Enjoy carbohydrate-rich foods alongside lean protein-poultry, seafood, lean beef or pork, eggs, low-fat dairy products, nuts, and whole soy foods-to help limit the spike in blood sugar that occurs after consuming carbohydrates.
Step 3. Stay active
Regular exercise can help maintain weight, but in addition, physical activity itself can help the body lower blood sugar levels and improve symptoms.
- Even a little exercise can help a lot. If you're having trouble getting exercise into your schedule, start by walking for 30 minutes each day on four to seven days each week.
- Focus on cardiovascular exercise rather than strength training. Cardiovascular exercise improves the health of the heart, lungs and overall circulatory system. This exercise also increases the body's ability to lose and maintain weight. Any exercise that gets the heart pumping can be considered a cardiovascular activity. This includes light exercise, such as walking, as well as more vigorous exercise, such as swimming and cycling.
Step 4. Quit smoking
If you currently smoke or use other tobacco products, stop as soon as possible. Quitting suddenly or right away is fine if you can, but if that's too difficult, opt for a chewing gum or nicotine patch treatment that will allow you to gradually get rid of your addiction.
Research shows that female smokers produce more androgens than non-smokers. Since high androgen levels are part of PCOS, smoking only exacerbates the problem further
Part 2 of 2: Surgery and Treatment
Step 1. Regulation of the menstrual cycle
Heavy and irregular periods are a common symptom of PCOS, so many treatments are aimed at regulating the menstrual cycle. This treatment usually includes medications that can increase progesterone levels while decreasing androgen production.
- As long as you're not trying to get pregnant, your doctor may recommend using low-dose birth control pills, especially if the pills contain a combination of synthetic estrogen and progesterone. With this additional dose of “female” hormones, the “male” androgens are reduced. The body also periodically takes a break from estrogen production, thereby minimizing abnormal bleeding and reducing the risk of endometrial cancer. Birth control pills can also get rid of any excess acne caused by PCOS.
- If you are unable to take birth control pills, your doctor may prescribe a progesterone treatment, which you will take for 10-14 days a month. This treatment can regulate your menstrual cycle and protect you from endometrial cancer, but it doesn't affect androgen levels in your body.
Step 2. Increase the body's ability to ovulate
PCOS often reduces a woman's fertility, making it more difficult to get pregnant. If you are trying to conceive as a PCOS patient, your doctor will likely prescribe treatments that can increase ovulation.
- Clomiphene citrate is an oral antiestrogen drug. You can take it at the beginning of your menstrual cycle to limit the amount of estrogen your body produces. Lower levels of estrogen in the body are often enough to stimulate ovulation.
- Gonadotropins are follicle-stimulating hormones and luteinizing hormones that are injected into the body. This method is also effective, but because it is more expensive than clomiphene citrate, it tends to be used less frequently. What's more, this injection increases your risk of multiple pregnancies (twins, triplets, etc.).
- If standard treatments don't work, your doctor may ask you to consider using in vitro fertilization.
Step 3. Learn about diabetes treatment. Metformin is the drug commonly used to treat type 2 diabetes, but there is strong evidence to suggest that it often also helps treat symptoms of PCOS
- Note that the FDA does not formally accept metformin as a PCOS treatment.
- This drug can improve the way the body uses insulin, thereby regulating blood sugar levels in the body.
- This drug can also decrease the presence of male hormones in the body. As a result, excess hair and acne will be reduced, menstrual cycles will become more regular, and the ability to ovulate can return.
- In addition, several studies have shown that metformin can help diet-and-exercise programs for weight loss provide better results.
Step 4. Treat excess male hormones
If you want to control PCOS symptoms related to excess androgen hormones in the body, your doctor may prescribe antiandrogen drugs. This medication is usually used to get rid of acne caused by PCOS and reduce excess hair growth.
- Spironolactone, a diuretic drug originally used as a treatment for high blood pressure, can lower androgen levels. However, your doctor will likely order regular blood tests to monitor your blood potassium levels and kidney function if you are taking this medicine.
- Finasteride is a medication that men take to treat hair loss, but for women, it can be used to lower androgen levels and reduce excess hair growth.
- This drug is often used with contraceptives because it can cause birth defects.
- Eflornithine is a topical cream that can block the effects of androgens on the skin, which can slow the growth of facial hair in women.
Step 5. Target unwanted hair directly
Lowering androgen levels should slow or stop excess hair growth, but if you need to remove unwanted hair before an androgen treatment starts, there are things you can do to target the hair directly.
- Ask about laser hair removal. Hair follicles are the target and are removed with a small laser beam.
- Learn about electrolysis. An electric current is applied directly to the hair roots, and as a result, the target hair is permanently damaged.
- Learn about depilatory. These are both prescription and non-prescription chemicals that are applied to the skin under unwanted hair. This chemical burns the hair.
- At home, you can also use wax treatments, razors, tweezers, and bleach to control unwanted hair.
Step 6. Ask the doctor about laparoscopic ovarian drilling
For women with PCOS who are trying to conceive but are not responding to traditional fertility treatments, doctors may recommend this surgical treatment.
- The surgeon will make a small incision in the abdomen, through which the doctor will insert the laparoscope (a small tube with a much smaller camera attached to the end). The camera takes detailed pictures of the ovaries and pelvic organs.
- Through an additional small incision, the surgeon will insert a surgical instrument that can use electricity or laser energy to punch holes in the follicle along the surface of the ovary. Because a small part of the ovary is damaged, the body can form scar tissue. However, this procedure can lower male hormone levels and cause ovulation for several months.
Step 7. Learn about bariatric surgery
If you are morbidly obese and cannot lose weight through normal means, your doctor may recommend bariatric surgery, more commonly known as "weight loss surgery."
- Morbid obesity means having a BMI of more than 40, or more than 35 if there is an obesity-related disease.
- After surgery, you will need to make healthy lifestyle changes to maintain or lose weight further. This includes dietary and exercise changes that are usually made when trying to lose weight.
