Conventional Medical Therapies for PCOS and Infertility

PCOS and infertility may be treated with a variety of medications and surgical therapies, depending on your symptoms.  Each therapy has its unique advantages and disadvantages.

As a first-line treatment, your doctor is likely to prescribe birth control pills or metformin (Glucophage).

Conventional medical and pharmaceutical therapies are listed below.

(If you are interested in alternative solutions, please visit our Natural Therapies for PCOS and Infertility page.)

3 Doctors Talk about Diagnosis and Medical Treatment

Steroid hormones

It is commonly believed that symptoms of polycystic ovary syndrome are caused mainly by an imbalance of multiple hormones, including estrogen, testosterone, progesterone, insulin, leptin, prolactin, cortisol and others.

• Oral contraceptives - birth control pills
• Progesterone - bioidentical
• Estrogens
• Corticosteroids

More Hormone Information

Since a major component of PCOS is a set of multiple hormonal imbalances, it's a good idea to better understand more about hormones.

• What Do Hormones Do?
• HRT Bombshell
• Natural vs. Synthetic Hormones
• Treatment Alternatives to HRT

Anti-Androgens

One of the most troubling hormones for this disorder is the excessive levels of testosterone.  There are a number of pharmaceuticals used to reduce the impact of testosterone and its metabolites.

• Spironolactone (Aldactone)
• Cyproterone acetate
• Flutamide (Eulexin)
• Finasteride (Propecia, Proscar)

Anti-Obesity Drugs

The inability to lose excess weight is among the most challenging aspects of this disease.  Most weight loss pills have a limited effect.  So don't expect too much from them.

• Orlistat (Xenical)
• Sibutramine (Meridia)

Insulin-Altering drugs

Many researchers believe that insulin dysfunction is the #1 driver of polycystic ovarian syndrome.  This is why insulin-altering pharmaceuticals like metformin are commonly prescribed.

• Metformin (Glucophage)
• Glitazones (Rosiglitazone - Avandia; Pioglitazone (Actos)

Fertility Agents

Lots of women are frustrated by their inability to become pregnant.  Various drugs are employed to force a change in hormones that will induce ovulation and help you become pregnant.  These medications don't always work and can have side effects if used repeatedly.

• Clomiphene citrate (Clomid, Serophene)
• Gonadotropin injections
• hCG (human choriuionic goinadotropin)
• GnRH (gonadotropin releasing hormone) Lutrepulse

Immune Modulating Agents

• Low-dose naltrexone

Prolactin Inhibiting Agents

The hormone prolactin can be too high in a small subset of women.  Pharmaceuticals to suppress prolactin production are not commonly used for this polycystic disorder and can have major side effects.  Vitex is an herbal extract that could help to relieve this problem.

• Bromocriptine
• Cabergoline

PCOS Surgery Options

If pharmaceuticals don't work or if there is some compelling reason to remove portions of or an entire organ, surgery is an option.   Be sure you understand both the benefits and risks.  Surgery is not reversible.

• Ovarian drilling
• Oophorectomy and hysterectomy

Assisted Reproduction and Pregnancy

The track record of IVF and other assisted reproduction methods to induce pregnancy in women with polycystic ovary syndrome is mixed.

• What Is Assisted Reproduction?
• Does IVF Have Genetic Risks?
• Prayer Helps IVF Pregnancy

Overweight People Get Less Respect from Doctors

If you are overweight, do you suspect that your doctor does not respect you? Do you wonder whether he or she thinks you are weak-willed and unwilling to lose weight?

A study by John Hopkins University shows that overweight people are less respected by their doctors. The fatter you are, the less they will respect you.

This isn't fair. It isn't right. It's unprofessional for a doctor to have a negative perception of you just because you are overweight. But that's the way it is.

They may not fully understand how difficult it is for you to lose weight. Perhaps they haven't performed a thorough diagnostic workup to find out WHY are you too heavy. There are lots of reasons why you can't lose weight besides how many calories you are consuming.

Research evidence suggests that when doctors don't respect their overweight patients, they tend to give out less information compared to lean patients. They may also be put off by the difficulty of examining a person with fatty skin folds. Poor grooming or body odor may also cause the doctor to have a negative perception.

If you sense that your doctor is uncomfortable with your body shape, find another doctor. Overweight and obesity is a very serious health problem, especially for women with PCOS. You should get help and advice from someone who really cares about you as a person and is not the least bit concerned with how you look.

Source: Huizinga MM et al, Physician Respect for Patients with Obesity, J Gen Intern Med. 2009 Sep 18.

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