PCOS is a chronic endocrinological condition that affects various facets of your health, including your reproductive, metabolic, and psychological systems. But with awareness, early identification of symptoms, and proper guidance, it can be managed. Lifestyle modification, dietary changes, and exercise are the first line of treatment and are the most effective solution for the long term, but some women may need medical management as well.And, Dr. Mansi Verma, a gynecologist at Veera Health’s online PCOS clinic, answers a few queries related to the same.
Do all women with PCOS need medications?
Short answer: no. Depending on the symptoms, medical history, and any co-morbidities, a doctor can evaluate if medications are needed. Some commonly prescribed medications are oral contraceptive pills or birth control pills, metformin (an insulin-sensitizing drug), and sometimes nutraceuticals like a myoinositol supplement. Some women with PCOS who aren’t able to conceive naturally after making lifestyle modifications can be prescribed ovulation-inducing drugs to help stimulate ovulation and increase the chances of pregnancy.
Medications are not a bad thing.
Taking medications is often seen as a failure to manage PCOS; this is not true. One of the reasons why women hesitate to take medication is because they want to either manage it on their own or “naturally”. But in PCOS, sometimes treating the underlying hormonal imbalance may require more than just making lifestyle changes.
Taking medications can actually give you the time you need to make lifestyle changes, lose weight, and stick to a healthy routine.Most medications prescribed for PCOS are only a temporary correction to help regulate hormones that are imbalanced. These medicines help achieve the required therapeutic window, which may not be achieved naturally for the patient. Having said that, taking medications is not a replacement for making lifestyle modifications. Lifestyle changes with medications make the therapy most effective.
What are common medications for PCOS?
There is no single pill or treatment method for PCOS. Medications are usually prescribed to correct hormonal imbalances, which can in turn mitigate symptoms like irregular periods, weight gain, hirsutism, acne, and scalp hair loss, among others.
Oral contraceptives or birth control pills
Apart from protecting against unwanted pregnancies, oral contraceptive pills (OCPs) are effective in regularising period cycles and reducing male hormone levels.OCPs don’t make you infertile, nor do they affect your chances of getting pregnant. Once you stop taking it, your ovaries are expected to function smoothly if the underlying cause of PCOS is managed by then.
Metformin
Metformin is a drug that is usually prescribed for diabetic patients to reduce blood sugar levels by improving the insulin sensitivity of the peripheral tissues (muscles). Since nearly 70% of women with PCOS suffer from insulin resistance, taking metformin can help reduce insulin resistance and thereby the production of androgens (male hormones). This can in turn help with weight loss, re-establish regular periods, and improve your chances of conceiving.
Anti-androgen drugs
Increased levels of androgens, or male hormones, can cause symptoms such as excess facial hair, acne, and scalp hair loss. Anti-androgen drugs are prescribed to help reduce male hormone levels and improve the symptoms. However, anti-androgen drugs are usually prescribed after lifestyle changes, and six months of oral contraceptive pill therapy haven’t shown improvements.
Ovulation-inducing drugs
Women with PCOS who have had trouble getting pregnant can be prescribed ovulation-inducing drugs. Letrozole is a widely used drug for the treatment of subfertility in women with PCOS and has been shown to be more effective than other medications such as clomiphene citrate. Other medications, such as metformin and gonadotropins, can also help stimulate ovulation.
Medications form an important part of treating PCOS, and there is nothing wrong with taking medications to manage your symptoms. Although not all women may need them, medications for PCOS are very effective in treating hormonal imbalances and can help you get on top of your condition and manage it with greater confidence.
