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PCOS Management and Treatment: Effective Ways to Fight PCOS

Polycystic ovary syndrome, or PCOS, affects 1 in 10 American women. Symptoms vary from person to person, so working with your gynecologist can help you find the right regimen to help mitigate and manage your symptoms. Read on to discover options for treatment that you can discuss with your doctor.

Pharmacologic interventions

Different types of medication may be prescribed to treat the symptoms of PCOS. PCOS causes irregular ovulation, which can affect the length of menstrual cycles. With PCOS, the egg is not released from the ovary due to hormonal imbalance and high levels of androgens.

Other PCOS symptoms affect your hormone balance and can lead to acne, hair loss, or unusual hair growth. Regulating your hormones via medication can help you find relief.

Menstrual dysfunction

Menstrual dysfunction is caused by irregular ovulation. There are multiple follicles in the ovaries, and with PCOS, the egg fails to mature and be released because of hormonal imbalance. This can cause lack of ovulation or ovulation that happens irregularly.

An egg that fails to mature remains in the follicle and develops into a cyst. Multiple cysts can interfere with a healthy egg being released, which can cause a lack of ovulation or ovulation that happens outside the typical time for an egg to be released (generally, in the middle of your menstrual cycle).

With PCOS, the egg fails to mature and be released because of hormonal imbalance. This can cause lack of ovulation or ovulation that happens irregularly.

To regulate your menstrual cycle, your doctor may recommend hormonal birth control pills containing estrogen and progesterone to decrease androgen levels and restore hormonal balance. Your gynecologist may also suggest the vaginal ring or the birth control patch, which also contain a combination of hormones similar to the pill. 

Another treatment for menstrual dysfunction is progestins, which regulate your periods. This treatment won’t offset the higher levels of testosterone in your body nor prevent pregnancy; however, you may wish to have a progestin-only IUD (intrauterine device) if you are sexually active and want to avoid pregnancy.

Hyperandrogenism

People with PCOS typically have elevated levels of male hormones, and this hormone imbalance can present in several different ways. Acne and greasy skin are common among people of all ages with PCOS, not just teens.

Other symptoms include thinning hair on the scalp and excessive hair growth on the face, chest, and back. Excess testosterone can cause your periods to cease, a condition known as amenorrhea, as well as causing ovarian dysfunction, which is when ovulation doesn’t occur. High androgen levels may cause high blood pressure.

Acne and greasy skin are common among people of all ages with PCOS, not just teens. Other symptoms include thinning hair on the scalp and excessive hair growth on the face, chest, and back.

Treatment hyperandrogenism can include prescription antiandrogens such as cyproterone acetate or spironolactone, which can help balance hormone levels. You may also be prescribed birth control pills to add female hormones to your system.

Infertility                 

With irregular ovulation, it can be difficult to determine when to have sex to conceive. Severe PCOS can lead to cessation of ovulation and your period entirely, which makes conception extremely unlikely.

To treat infertility for women with PCOS, your doctor may prescribe clomiphene, which increases your chances of releasing a viable egg. Letrozole, a breast cancer medication, may also be prescribed in conjunction to stimulate the ovaries.

Insulin resistance

Insulin is a hormone that regulates your blood sugar and allows your cells to extract the nutrients needed from your bloodstream. Insulin resistance can make this process more difficult, leading to persistent high blood sugar, prediabetes, and eventually Type 2 diabetes.

PCOS isn’t the only risk factor for developing diabetes: studies show that women who have a higher BMI and higher resting glucose levels have a greater chance of developing diabetes. 

Treatment of Type 2 diabetes may include a prescription for metformin, which can increase insulin sensitivity and, when paired with healthy weight loss and a managed diet, can help reverse prediabetes and even diabetes. In addition, metformin may increase your chances of becoming pregnant.  

Hirsutism

Hirsutism is the growth of excess unwanted body hair in places including the face, chest, and back. Many women with PCOS may feel self-conscious about this condition, but reversing the progression of PCOS also reverses hirsutism.

Hirsutism is caused by elevated amounts of testosterone and other male hormones.

While women have androgen and testosterone in their bodies, these hormones are at very low levels and are balanced out by higher levels of estrogen and progesterone. The condition can be reversed, although the effects aren’t immediate. Treatment for hirsutism can include hormonal birth control to help moderate your hormone levels and reduce the thickness, darkness, and amount of hair.

Hirsutism is caused by elevated amounts of testosterone and other male hormones. Treatment for this condition can include hormonal birth control to help moderate your hormone levels and reduce the thickness, darkness, and amount of hair.

The excess hair can also be removed with traditional hair removal methods, such as shaving, waxing, depilatories, or even laser treatments. Consult a dermatologist or aesthetician about which method will work best for the results you want. Shaving, for instance, is the least expensive, although it needs daily maintenance. Waxing and laser hair removal have longer-lasting results but can be pricier and more painful.

Lifestyle changes

While some aspects of PCOS can be controlled by prescription medication, there are a few easy lifestyle changes you can make to naturally reverse the condition. As a bonus, these changes will improve your fertility and your likelihood of a healthy pregnancy if you’re trying to conceive and will have positive impacts on your health even if you’re not.

Maintain a healthy weight

PCOS is linked to obesity. Fat, or adipose tissue, actually secretes hormones that can create a hormone imbalance capable of aggravating PCOS. However, many studies show that losing as little as 5% of your body weight if you're overweight or obese can help reduce PCOS symptoms. In fact, many women who were obese and suffered from PCOS have found that reaching a healthy BMI (18 – 24.9) reversed their condition and allowed them to both conceive easily and enjoy a healthy pregnancy.

Many studies show that losing as little as 5% of your body weight if you're overweight or obese can help reduce PCOS symptoms.

If you are overweight or obese, speak with a registered dietician about creating a healthy eating plan for you. Plenty of lean proteins, whole grains, vegetables, and fresh fruits instead of processed food and refined sugar can help you lose weight. When you’re trying to lose weight, be sure to work with your doctor to ensure that you’re making healthy, lasting lifestyle changes that you can maintain.

Exercise regularly

The US Department of Health defines “enough exercise” as 150 minutes of vigorous exercise (running or cycling) or lower impact exercise (brisk walking or yoga) per week. Getting regular exercise helps naturally regulate your mood and may help regulate your hormones as well.

The health benefits of regular exercise can help the rest of your overall PCOS treatment, from boosting your mood to giving you more restful sleep. Regular cardio exercise — getting your heart rate at 75% of the maximum your doctor recommends — 4-5 times per week for at least 30 minutes can help increase your insulin sensitivity and help reverse a diabetic condition.

Rethink your diet

Whole foods and a balanced diet may help you lose weight naturally and reduce PCOS symptoms. Many women with PCOS have found success following a ketogenic meal plan, also called the keto diet. This type of plan removes most of the carbohydrates from your diet and replaces them with healthy dietary fats and a substantial amount of protein. Carbohydrates tend to make your blood sugar spike and dip, while removing them stabilizes blood sugar levels. This, in turn, helps with insulin resistance and may have a positive effect on your hormonal balance.

Whole foods and a balanced diet may help you lose weight naturally and reduce PCOS symptoms. Many women with PCOS have found success following a ketogenic meal plan, also called the keto diet.

You should consult your doctor before starting a ketogenic diet. Such a diet essentially retrains your body to use fat for energy instead of carbs. This necessitates eating plenty of healthy fats, such as cheese, avocado, and nuts. Healthy fats are satiating, which means that just a small amount can help you feel full for a longer period. The calorie deficiency that you produce by eating like this encourages your body to draw on its fat reserves, further increasing the weight loss that can help reverse PCOS.

Surgery

If none of these treatments are successful, your doctor may recommend surgery on your ovaries. Most PCOS surgeries are done laparoscopically — using precision instruments to operate through a small incision. The surgery entails removing part of the ovaries, including the follicles, to stimulate ovulation. While surgery may help you begin ovulating and menstruating more regularly, it may not cure your PCOS, as hormonal imbalances may persist after surgery.

Most PCOS surgeries are done laparoscopically — using precision instruments to operate through a small incision. The surgery entails removing part of the ovaries, including the follicles, to stimulate ovulation.

Surgery carries the risk of painful adhesions, as well as tenderness or numbness in your lower abdomen, and should be considered a major step under the care of a proper surgeon.

Treating PCOS is a comprehensive process that should include doctor's recommendations. LIfestyle changes, using medication to balance your hormones and alleviate your symptoms, and even surgery are all options that can help reduce the symptoms or even reverse the condition entirely.

 

https://emedicine.medscape.com/article/256806-treatment
https://www.mayoclinic.org/diseases-conditions/pcos/diagnosis-treatment/drc-20353443
https://www.webmd.com/women/treatment-pcos#1
https://www.diabetes.co.uk/conditions/polycystic-ovary-syndrome.html
https://www.endocrine.org/news-room/current-press-releases/researchers-reveal-link-between-pcos-type-2-diabetes
https://www.verywellhealth.com/hirsutism-in-women-with-pcos-2616644
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3289164/

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