You Asked For It: Treating PCOS

In an earlier post, Christy asked about PCOS and its treatment. Polycystic Ovarian Syndrome is a complex diagnosis that is relatively easy to treat.

Here are my responses to Christy's questions:

How do you treat [PCOS]?

PCOS is sometimes referred to now as "metabolic syndrome" because the term more accurately reflects the entire condition. For example, not all women with PCOS have ovaries with many cysts.

The goal of treatment is ovulation. Treatment usually consists of oral medication (clomiphene citrate, more commonly referred to by one of its brand names, Clomid).

In the past, another drug, Metformin, was frequently administered in conjunction with Clomid. A couple of years ago, a large study found no advantages to using Metformin strictly for the purpose of getting pregnant. (I wrote about that finding in my November 2006 newsletter.)

How effective is Clomid? Does it work every month?

Clomid is generally effective within the first three cycles of use. Depending on several factors, I may prescribe the medication be used in conjunction with intrauterine insemination (IUI) or timed intercourse.

If a patient is Clomid resistant, what is the next protocol?

If a patient's ovaries are resistant to Clomid, the next step is often gonadotropins, which are administered by injection. Patients who also have abnormal glucose/insulin levels will be prescribed Metformin.

As a side note, it's important that women with PCOS are made aware of the links between that and more serious health conditions like heart disease and diabetes. I encourage all of my patients to make healthy lifestyle changes as needed, not only to increase their chances for pregnancy, but to promote overall better functioning of their total body.

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