Treatment Options for Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) affects 10% of women of childbearing age. It is a chronic condition, similar to blood pressure or diabetes, and requires long-term management. While sustainable lifestyle changes are the most effective way to manage PCOS, there are also medical interventions that can significantly help.

Weight Management
Women with PCOS who experience significant weight gain are, on a biochemical level, hungrier than those without PCOS. We all produce a hormone called leptin, which signals to the brain that we are full. For many PCOS patients, higher insulin levels caused by the condition decrease leptin production, making weight gain likely and weight loss more challenging.
So what can be done? Dr. Daoud discusses options with her patients, ranging from simple lifestyle changes to more invasive approaches, so they can choose what is most likely to work for them.
Successful weight management positively impacts not only weight and mobility, but many other PCOS symptoms, such as infertility, irregular periods and pre-diabetes.

Weight Management Options

• Independent management: Switch to a Mediterranean diet and consume unprocessed foods that resemble natural sources. Increase physical activity levels.
• Work with a nutritionist: Qualified nutritionists can help patients use food as medicine in managing PCOS. The goal is to establish sustainable, enjoyable, new eating patterns that promote well-being.
• Medically supervised weight loss: A board-certified physician trained in obesity can prescribe medications to aid in weight loss. Medicines like Ozempic® and Mounjaro™ improve leptin signaling, helping patients feel satisfied with smaller amounts of food.
• Bariatric surgery: In cases where significant weight loss is needed, bariatric surgery may be the best option.

Hirsutism and Male Pattern Baldness
Another common issue associated with PCOS is increased body hair, including dark and coarse hair in areas where women typically do not grow such hair.
Non-medical options to address unwanted hair growth include laser hair removal and electrolysis. Laser hair removal is most effective for individuals with light skin and dark hair. Patients with dark skin or blonde hair may need to explore other options.
Medical interventions are also available, including Eflornithine, which slows hair growth and Spironolactone, a blood pressure medication that can also treat acne, hair loss and male pattern baldness by decreasing male hormone levels.

Protecting the Endometrial Lining
Irregular or infrequent periods are one of the first signs of PCOS. If the uterine lining (endometrium) does not shed regularly, it thickens over time. This can lead to two issues: firstly, the built-up lining outgrows its blood supply, resulting in sudden, heavy periods; secondly, the lining can accumulate genetic mutations, potentially leading to cancer.
To improve quality of life and reduce cancer risks, Dr. Daoud recommends hormonal birth control. Hormonal options such as the birth control pill, IUD, birth control ring or birth control patch are acceptable. For individuals unable to take regular estrogen or who prefer not to take daily tablets, Provera® (medroxyprogesterone) is a progesterone-only option.

Infertility
The Stony Brook PCOS Center includes fertility doctors as part of the team. Restoring ovulation is one of the primary challenges when it comes to PCOS because pregnancy is not possible without ovulation. Medications like Letrozole or Clomid are among the first-line options to help restore ovulation, improve the chances of getting pregnant, maintaining a pregnancy and bringing a healthy baby home.

To make an appointment, call (631) 444-4686. To learn more about PCOS and all the services provided, please visit our website at: stonybrook.info/aboutpcos