👩⚕️ PCOS is the most common endocrine disorder in young women, affecting up to 10% of reproductive-age women. It’s often linked to insulin resistance and high androgen levels, causing irregular periods, infertility, obesity, and hirsutism. 🤔
🔑 Treatment depends on whether pregnancy is the goal...
- Metformin: Improves insulin sensitivity, lowers androgen levels, restores menstrual cycles, and helps with ovulation. 🌸 It's sometimes continued in pregnancy to reduce miscarriage or gestational diabetes risks.
- Glitazones (e.g., rosiglitazone, pioglitazone): Used if metformin isn’t tolerated, but avoid if pregnancy is planned due to safety concerns.
- 🚫 Clomiphene (Clomid): Stimulates ovulation for women trying to conceive. It’s often used with metformin for better results.
- 💉 Oral contraceptives (OCs): Help regulate menstrual cycles and reduce androgens for those not trying to conceive.
- 🌙 Spironolactone: Reduces hirsutism when OCs alone aren’t enough. Avoid during pregnancy. 🚫
- ⚖️ Lifestyle changes like weight loss and exercise are key! Losing just 5% of body weight can lower androgen levels and restore menstrual cycles. 🏃♀️💪
- ‼️ Warning: Women who don't want to conceive may regain fertility after treatment. Discuss birth control options! 🍼
References
- Guzick DS. Polycystic ovary syndrome. Obstet Gynecol. 2004;103(1):181-193.
- Barbieri RL. Metformin for the treatment of polycystic ovary syndrome. Obstet Gynecol. 2003 Apr;101(4):785-93.
- Ganie MA, Khurana ML, Eunice M, et al. Comparison of efficacy of spironolactone with metformin in the management of polycystic ovary syndrome: an open-labeled study. J Clin Endocrinol Metab. 2004;89(6):2756-2762.
