Treatment Options for PCOS

If you have been diagnosed with polycystic ovarian syndrome or PCOS as it is known, you will be glad to hear that there are a number of options available to treat this medical condition.
In this article we take a look at the treatment options ranging from lifestyle changes to specialised medicines and find out how to know which treatment is right for you.

What treatment options are available for PCOS

PCOS is actually an endocrine disease of the ovaries. It is also a chronic medical condition for which there is no known cure. However, like other chronic medical problems such as asthma or diabetes, it can be well managed over the long term.

The cornerstone of treatment for those with PCOS is weight loss. This treatment is prescribed for all women diagnosed with PCOS, whether they are simply managing their condition or if they are treating PCOS with the objective of falling pregnant.

The reason is simple: excess weight not only contributes to metabolic syndrome, it also adversely affects other crucial health factors, such as cholesterol, insulin levels and blood pressure. Furthermore, PCOS can also interfere with ovulation.

It is crucial to lose some weight to improve all these adverse health conditions associated with PCOS.

One way to know where you are at right now in terms of a healthy weight is the body mass index or BMI. The formula is BMI = kg/m2 where kg is your weight in kilograms and m2 is their height in metres squared. You can use an online calculator to work out your BMI.

A BMI between 18 and 25 is considered normal. A BMI above 25 is considered overweight while a BMI over 30 is considered obese, and above 35 – morbidly obese. The objective of knowing your BMI is to provide a starting point from which to improve over the long term.

At Cape Fertility, we usually aim for an initial target of losing 5% of your body weight and to reach a healthy BMI. So, if for example you weigh 100kgs, you might start off with an initial target of losing 5% of your body weight, or 5kgs.

Studies have shown that even losing just 5% of body weight is often enough to make a significant difference to PCOS symptoms. It will also be extremely helpful in terms of improving your cholesterol, your insulin levels and blood pressure, and its also potentially going to help you ovulate on your own, which will also increase the chance of conception.

Lifestyle changes to lose weight sustainably is the treatment prescribed for all women diagnosed with PCOS, whether they are simply managing their condition or if they are treating PCOS with the objective of falling pregnant.

It is particularly important for moms-to-be, not only to assist them to fall pregnant, but also to ensure that they go into a pregnancy in good health – with a normal BMI, and insulin levels, cholesterol and blood pressure all well controlled – improving the chances of a healthy pregnancy and a healthy baby.

Because weight loss is mostly achieved through eating correctly, you might want to consult a dietician. It is also important to find a form of exercise that you enjoy.

At Cape Fertility, we follow the recommendations provided by the European Society of Human Reproduction and Embryology or ESHRE.

ESHRE recommends decreasing your calorie intake by about 30%. Some of our patients use one of the many apps online to assist them in keeping track of what they are eating and understanding their intake of daily calories, so they can make improvements.

When it comes to exercising, one commonly cited goal is 10,000 steps a day. For women with PCOS who are reducing their weight, ESHRE recommends 250 minutes of moderate intensity exercise a week, which is about 50 minutes of moderate intensity exercise, five times a week. If you do more vigorous exercise, such as running or high intensity interval training, five sessions of 30 minutes each per week is recommended.

The next step is to bring your blood pressure and your cholesterol under control, and managing your insulin levels to avoid insulin resistance and Type 2 diabetes.

Losing weight and exercising, will definitely contribute to improving these health factors, further intervention – perhaps in the form of medication – may be required.

This is because there is another symptom of PCOS many women experience and that often requires treatment: prolonged and painful periods. With PCOS women often do not have regular periods – sometimes with two to three months between cycles. During this time, a thick lining builds up in the uterus, which means that the delayed period is heavy with lots of clots and extended – anywhere from 10 days to three weeks, before disappearing again for two to three months.

There are different options for treating irregular periods and the right option here will also depend on whether or not you are trying to fall pregnant.

Contraceptive pills, Provera, or a Mirena are among the first line treatment options for those who are not trying to fall pregnant.

There is a wide selection of contraceptive pills available and not every kind of pill will fit every woman. Some contraceptive pills will also reduce the level of androgens in the body, which will help clear up acne and decrease the rate of growth of excess body hair associated with PCOS. So, it’s important to talk to your doctor about this to find the one that works for you.

Provera, a form of progesterone, can be taken for about 12 days every month and is another possible treatment to ensure a regular period every month.

The Mirena is an intrauterine contraceptive device that is also used to treat abnormal bleeding. It can be fitted in a doctor’s room and it can stay for up to five years. Most women will actually stop having a period with a Mirena.

It is important to realise that these treatment options are not quick fixes – it is usually recommended that the prescribed treatment is followed for six months before adding further medication. This might include adding specific medication that decreases testosterone levels, blood pressure medication, or medicines to reduce insulin levels such as Metformin or Glucophage.

Fertility drugs are also effective, but this treatment should only be offered by qualified and registered fertility specialists and must be monitored very carefully.

Which treatment is right for you?

It is important to know that not all women with PCOS display all the symptoms, or even the same intensity of symptoms. In addition, some of the symptoms may be caused by a condition other than PCOS.

The only way to know for certain which PCOS treatment is right for you is to undergo the necessary tests and investigations at an accredited and recognised clinic, where a fertility specialist with state-of-the-art equipment and years of experience will be able to make a professional determination and provide you with the best advice for the right treatment to manage this chronic medical condition and even to achieve a pregnancy.

If you have been diagnosed with PCOS or suspect that you have PCOS, we would like to invite you to come and meet one of our specialists by clicking here

At Cape Fertility, we value each individual person and we look forward to providing you with individualised and personalised care, affordable quality fertility treatment, and higher success rates at our purpose-built premises in the beautiful city of Cape Town.