PCOS Treatment / PCOD Treatment
WHAT ARE THE VARIOUS MEDICATIONS THAT ARE USED IN PCOD TREATMENT / PCOS TREATMENT?
1. Medications to Regulate the Menstrual Cycle
The most common form of PCOS treatment is the contraceptive pill or birth control pill; Even if you are not sexually active, birth control pills may be prescribed by your health care provider because they contain the hormones that your body needs to treat your PCOS. These birth control pills help in:
- Correct the hormonal imbalance
- Regulate your menstrual periods
- Lower the risk of endometrial cancer (which is slightly higher in young women who don't ovulate regularly)
- Prevent an unplanned pregnancy if you are sexually active
- They may also improve your androgen-related acne problems, male-type hair growth, and male-pattern hair loss.
2. Medications to Reduce Insulin Resistance
Metformin is only FDA-approved treatment for insulin resistance and diabetes. Metformin is a useful medication in PCOS patients as it helps to improve fertility, reduce miscarriages and gestational diabetes, and reduce long-term health problems. The use of metformin in pregnancy remains controversial although the risk appears to be small. So the use of this medicine for treating PCOS symptoms should be discussed with your doctor.
3. Infertility Medications
In PCOD patients suffering from Infertility, the main aim of using medications is to make sure there is ovulation happening. Clomid or Letroze are the first line of medication used in treatment of infertility in PCOD patients which help in ovulation. Patients are educated about fertile period (the time when egg comes into the fallopian tubes from the ovary) and with the help of ovulation prediction kits they are advised to have intercourse. This might not be helpful in PCOD patients with persistent high LH levels.
Because of the connection between PCOS and insulin resistance, medications that are normally used to treat diabetes, namely Metformin, may be used to increase insulin sensitivity. By increasing the body's response to insulin, it is thought that the ovary may not make as many androgens, which increases the likelihood that ovulation will occur. Metformin may also reduce the levels of circulating androgens, even if you are not trying to conceive. This will help regulate your menstrual cycle and reduce the distressing symptoms that you may be experiencing. Some women may need to take both Clomid and Metformin in order to ovulate.
In cases where oral medication is a failure, hormonal injections like Gonadotrophins are used. Each month, Gonadotrophins namely Follicle Stimulating Hormone (FSH) is secreted by the pituitary which makes an egg / follicle grow. Hence, Gonadotrophin injections directly increase the amount of FSH circulating in the body, promoting the growth and development of a mature egg. There is a risk of ovarian hyperstimulation when PCOD patients receive gonadotrophin injections; therefore it's mandatory to monitor progress through ultrasound and blood tests. Once the doctor feels that you are close to ovulation, your are either advised to have intercourse (Ovulation induction with timed intercourse) or the doctor plans for Intra uterine insemination (IUI).
SURGICAL ROLE IN PCOD PATIENTS
Surgery has got a minimal role in PCOD patients. However, therapeutic ovarian drilling can be performed where in the cysts of the ovary are punctures under laparoscopic guidance. This treatment results in a dramatic lowering of male hormones within days. Studies have shown that up to 80% will benefit from such treatment. Women who failed to ovulate with letrozole or metformin therapy will respond when rechallenged with these medications after ovarian drilling. Interestingly, women in these studies who are smokers rarely responded to the drilling procedure. Pelvic adhesions or ovarian failure are few of the side effects that can be rarely anticipated after laparoscopic ovarian drilling.
ROLE OF ASSISTED REPRODUCTION IN PCOD PATIENTS
When medical and surgical line of treatments has failed assisted reproductive techniques like IUI or In Vitro Fertilization (IVF) are the next options to be considered. Success (pregnancy) rates with IVF in PCOS patients are generally excellent, although a higher risk of Ovarian Hyperstimulation (OHSS) exists, especially in IVF patients who become pregnant. In such high risk cases of OHSS Natural cycle IVF with IVM - In Vitro Maturation of oocytes is a good option.
Necessity for oocyte donor is a rare option in PCOD patients, kindly discuss with your clinician for further advice and information on role of oocyte donation in PCOD patients.
LIFE STYLE MODIFICATION FOR PCOD PATIENTS
Thanks to the advancing medical technology, a number of PCOD treatments are available today that can help you manage PCOD. However, the first important step in PCOD treatment is weight reduction. A low carbohydrate diet with less calories and high protein and high fiber diet with a regular exercise routine can help your body increase its response to insulin, and possibly decrease androgen production. This may help reduce symptoms, restore normal menses and make it easier to conceive. While there are medications that can help manage the symptoms you are experiencing, losing weight is the best thing you can do to help treat the disease.
What is the Best PCOS Diet?
PCOS and weight gain go hand in hand. With the growing awareness of the obesity crisis, you will find articles with varying diet plans all over the web that promise dramatic results. Many of these provide little or no scientific data to back up their claims. Most of these plans are difficult to maintain and often people go back to their old ways of eating after some time, and put all if not more weight back on. This is particularly true of women with PCOS. Because dieting and weight loss is so difficult, it is not uncommon for women to try many different diet plans leaving them to wonder, what is the best PCOS diet?
There is no magical diet which can assure 100% weight loss. Good nutrition and regular exercise are the keys to seeing long-term, consistent results. While weight loss may not be dramatic, eating healthy foods and staying active are the best way to maintain good health. It certainly is beneficial to cut back on simple, or white, carbohydrates like white sugar, rice, potatoes and pasta. However, adding in complex grains and carbohydrates do contribute many important health benefits like fiber and antioxidants.
Following are few helpful hints for healthy eating habits:
(Adapted from: http://www.youngwomenshealth.org/pcos_nutrition.html)
|Sweetened juice, canned fruit in heavy syrup, or sweetened applesauce
||Fresh fruits or frozen/canned fruit without added sugar, or unsweetened applesauce|
|Starchy vegetables such as potatoes, corn, and peas
||Non–starchy fresh vegetables or frozen/canned vegetables such as broccoli, spinach, and carrots|
|Refined grains made with white flour such as white bread, pasta, bagels, and white rice
||Whole grains such as whole wheat pasta, brown rice, and whole wheat bread|
|Sugared cereals such as Lucky Charms®, Fruit Loops®, or Frosted Flakes®, and other sweetened grains such as cereal bars (Nutrigrain Bars®), breakfast pastries (PopTarts®), and donuts
||High fiber cereals such as Kashi®, shredded wheat, and All Bran®. (Try to have a cereal that has at least 5 grams of fiber per serving or sprinkle ˝ a cup of bran cereal or unprocessed bran on a low–fiber cereal to increase the fiber)|
|Sugary drinks such as soda or juice
||Sugar–free or low sugar drinks such as water, diet soda, Crystal Light®, Fruit20®, Powerade Zero®, Vitamin Water 10®, and seltzer water|
|Sugary foods such as cookies, cakes, and candy
||Sugar–free, light, or "no sugar added” foods such as Jello®, popsicles, yogurt, or pudding|