PCOS / PCOD Treatment
Polycystic Ovary Syndrome (PCOS) and Polycystic Ovary disease (PCOD) are the most common hormonal disorders affecting women today. At Oasis, we offer different treatments for PCOS/ PCOD. Treatment will be based on your symptoms, your desire for pregnancy and to lower your chances of getting heart disease and diabetes. Many women will need a combination of different treatments to meet these goals.
PCOS / PCOD TREATMENT OPTIONS
- 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 as they contain the hormones that your body needs to treat your PCOS. These birth control pills help in:
Medications to Reduce Insulin Resistance
- Correcting the hormonal imbalance
- Regulating your menstrual periods
- Lowering the risk of endometrial cancer (which is slightly higher in young women who don't ovulate regularly)
- Preventing an unplanned pregnancy (if you are sexually active)
- Improving your androgen-related acne problems, male-type hair growth, and male-pattern hair loss.
Metformin is the 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, gestational diabetes, and many long-term health problems. Although the risk appears to be small, use of Metformin in pregnancy remains controversial. Use of this medicine for treating PCOS should be discussed with your doctor.
For PCOD patients suffering from infertility, Clomid or Letroze are the first line of medication used for ovulation stimulation. Patients are educated about fertility period 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. Due to the connection between PCOS and insulin resistance, some patients might need to take Metformin along with Clomid or Letroze to increase insulin sensitivity.
In cases where oral medication is a failure, hormonal injections like Gonadotrophins are used. Gonadotrophins injection (Follicle Stimulating Hormone) promotes the growth and development of a mature egg. However there is a risk of ovarian hyperstimulation, hence it's mandatory to monitor progress through ultrasound and blood tests. Once the doctor feels that you are close to ovulation, you are either advised to have intercourse (Ovulation induction with timed intercourse) or the doctor plans for Intra uterine insemination (IUI).
Surgery plays a minimal role in PCOD patients. However, therapeutic ovarian drilling can be performed on some women who do not respond to fertility medicines. In this procedure, the cysts of the ovary are punctured 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. 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.
IUI / IVF Treatments
When medical and surgical line of treatments fails, assisted reproductive techniques like IUI or In Vitro Fertilization (IVF) are recommended. Pregnancy rates with IVF in PCOS patients are generally excellent, although a higher risk of Ovarian Hyperstimulation (OHSS) exists. 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. This treatment needs to be further discussed with your doctor.
Life Style Modifications
PCOS and weight gain go hand in hand. Many women with PCOS are overweight or obese. Keeping a healthy weight by eating healthy foods and exercising is another way woman can manage PCOS. Even a 10 percent loss in body weight can restore a normal period and make a women’s cycle more regular.