You and your doctor should talk about what your goals are so you can come up with a treatment plan. For example, if you want to get pregnant and are having trouble, then your treatment would focus on helping you conceive. If you want to tame PCOS-related acne, your treatment would be geared toward skin problems.
Many women with PCOS are overweight or obese. Losing just 5% to 10% of your body weight may ease some symptoms and help make your periods more regular. It may also help manage problems with blood sugar levels and ovulation.
Since PCOS could lead to high blood sugar, your doctor may want you to limit starchy or sugary foods. Instead, eat foods and meals that have plenty of fiber, which raise your blood sugar level slowly.
Hormones and Medication
Birth control is the most common PCOS treatment for women who don't want to get pregnant. Hormonal birth control -- pills, a skin patch, vaginal ring, shots, or a hormonal IUD (intrauterine device) -- can help restore regular periods. The hormones also treat acne and unwanted hair growth.
If birth control doesn't stop hair growth after 6 months, your doctor may prescribe spironolactone (Aldactone). It lowers the level of a type of sex hormone called androgens. But you shouldn't take it if you're pregnant or plan to become pregnant, because it can cause birth defects.
When a healthy diet and regular exercise aren't enough, medications can make losing weight easier. Different drugs work in different ways. For example, orlistat (Alli, Xenical) stops your body from digesting some of the fat in your food, so it may also improve your cholesterol levels. Belviq (Lorcaserin) makes you feel less hungry. Your doctor will prescribe the medication they think will be the most successful for you.
Weight loss surgery could help if you're severely obese and other methods haven't worked. The change in your weight afterward can regulate your menstrual cycle and hormones and cut your odds of having diabetes.
A process like electrolysis (a way to remove individual hairs by using an electric current to destroy the root) or laser therapy destroys hair follicles. You'll need several sessions, and though some hair may come back, it should be finer and less noticeable.
Your doctor may prescribe medication to help you get pregnant. Clomiphene and letrozole (Femara) encourage steps in the process that trigger ovulation. If they don't work, you can try shots of hormones called gonadotropins.
A surgery called ovarian drilling might make your ovaries work better when ovulation medications don't, but it's being done less often than it used to. The doctor makes a small cut in your belly and uses a tool called a laparoscope with a needle to poke your ovary and wreck a small part of it. The procedure changes your hormone levels and may make it easier for you to ovulate.
With in vitro fertilization, or IVF, your egg is fertilized outside of your body and then placed back inside your uterus. This may be the best way to get pregnant when you have PCOS, but it can be expensive.