Polycystic ovarian syndrome (PCOS) is a lifelong condition. Although there is no cure at this time, treatments are available to manage the condition, relieve its symptoms and reduce the risk of related complications.

If any of the more serious complications associated with PCOS are present, such as diabetes, heart disease or uterine cancer, physicians will immediately begin aggressive treatment of these conditions. In some cases, treatment for these conditions can be long-term.

Any PCOS treatment plan should include:

• Weight management. Obesity or unwanted weight gain are commonly associated with PCOS. Patients are encouraged to consult with a physician and/or registered dietician to formulate a weight control plan tailored to their specific needs. This plan should include an exercise regimen for the healthy management of weight. According to the American Society for Reproductive Medicine (ASRM), losing as little as 5 to 10 percent of total body weight may help women resume normal ovulation. In addition, a healthy diet and regular exercise are the best ways to prevent long-term consequences of PCOS such as cardiovascular disease and diabetes.
  
  
• Removal of unwanted body hair. It is not medically necessary to remove the unusual hair growth associated with PCOS (hirsutism). However, many women choose to take advantage of options such as electrolysis, waxing or laser therapy for aesthetic reasons.
  
  
• Quitting smoking (if applicable). Smoking increases the risk of complications commonly associated with PCOS (e.g., heart disease). It is also beneficial for women who want to become pregnant.
  
  
• Regular gynecological examinations. Yearly visits to a gynecologist for pelvic exams are an important part of PCOS treatment. They can detect early signs of either ovarian cancer or uterine cancer, which is a risk for women who have irregular periods or do not menstruate.
  

  

For women with PCOS who are trying to conceive, treatment varies and may include:

• Ovulation drugs. Medications that stimulate ovulation. The main fertility issue that affects women with PCOS is the lack of ovulation. Therefore, ovulation medications are the first line of treatment for women with PCOS who wish to become pregnant. For women with PCOS, the ovulation drug most commonly used is clomiphene citrate. A second, more aggressive therapy may be used, involving injectable drugs called gonadotropins. These drugs trigger ovulation in almost all women with PCOS and can lead to pregnancy in most cases. Potential side effects of gonadotropins may include hot flashes, vaginal dryness and loss of bone density, among others. In addition, all ovulation drugs may put PCOS patients at an increased risk for multiple births.
  
  
• Antidiabetic agents. Medications that increase the body’s sensitivity to insulin normally used in the treatment of type 2 diabetes. This type of treatment may be prescribed with clomiphene if clomiphene therapy alone does not result in pregnancy. Metformin is also prescribed for women with PCOS who are not trying to conceive. The drug can treat two other common symptoms of PCOS, weight gain and insulin resistance.
  
  
• Laparoscopic ovarian drilling. An outpatient surgery that involves the use of electrical or laser energy to burn holes in enlarged follicles on the surface of the ovaries. This type of surgery stimulates ovulation, regulates the menstrual cycle and increases a patient’s chances of becoming pregnant. However, the procedure is only used if other, less invasive methods fail because it increases the risk of pelvic adhesions, which can cause chronic pelvic pain. For women who smoke, this type of surgery may not be successful.
  
  
• In-vitro fertilization (IVF). Another option for women with PCOS who are trying to conceive is IVF. This procedure involves retrieving mature eggs from a woman, fertilizing them with a man’s sperm in a laboratory and implanting the embryos in the uterus three to five days after fertilization. IVF is sometimes recommended by physicians to reduce the chance of having multiple births, which is higher when using ovulation drugs.

For women not trying to conceive, treatment usually centers on restoring a normal menstrual cycle and may include:

• Birth control pills, typically incorporating estrogen and progestin. These also help reduce the risk of endometrial cancer.
  
  
• Corticosteroids (steroids used to suppress androgen production by the adrenal glands).
  
  
• Anti-androgens (e.g., spironolactone, flutamide).
  
  
• Gonadotrophin-releasing hormone (GnRH) agonists (e.g., leuprolide). These suppress the production of sex hormones, and induce a temporary menopause in premenopausal women. However, GnRH agonists may have significant side effects, such as hot flashes and bone demineralization, and are usually prescribed for no longer than six months.

These types of medications also reduce skin problems such as acne, and may cut down on hirsutism for as long as they are taken.

Because the primary cause of PCOS is unknown, there are no known prevention methods. However, early detection of PCOS is critical. It is important for a young woman to visit a gynecologist after her first menstruation (menarche) and maintain a regular gynecological checkup schedule. Treatment that begins at an early age has a better chance of preventing the more serious risks associated with the disorder.