There is no cure for PCOS, however, PCOS can be managed through lifestyle modifications and with appropriate medications.
The goals of managing PCOS are to reduce symptoms, improve physical-, emotional- and mental health, prevent long-term health conditions and improve quality of life. For women seeking to become pregnant, management of PCOS may also include assistance with fertility and providing support during pregnancy. Your health care team will work with you on the symptoms that are most important to your health and quality of life.
Because PCOS can have many symptoms, it is important to have a multidisciplinary health care team. Depending on your symptoms, this may include your GP, an endocrinologist, a gynaecologist, a dietician, a psychologist, exercise physiologist or physiotherapist, a dermatologist and fertility specialists.
Physical activity and diet – Taking part in regular physical activity (e.g. walking, household chores, sports) and having a healthy and balanced diet have many benefits for PCOS. Around 150 minutes of moderate to vigorous physical activity every week is recommended4.
These benefits include:
- Improving your emotional and mental health
- Controlling your blood sugar levels, which can help to reduce insulin resistance.
- Helping to regulate your periods
- Improving your fertility and chance of getting pregnant
- Managing your weight
- Having healthier skin
- Feeling fitter
There is no specific diet recommended for women with PCOS. However, women with PCOS who need to lose weight should aim for a calorie intake of 1200 calories per day, and 250 minutes a week of moderate-vigorous physical activity4. It is more important to find physical activities that you enjoy doing, and eat healthy, tasty foods, to promote healthy living over the longer term.
Hair removal – Excess hair can be removed through various methods, including waxing, threading, laser therapy, electrolysis and hair removal (depilatory) creams.
It is very important to be aware of and look after your emotional and mental health. Depression, anxiety and low mood are common in women with PCOS. PCOS is also associated with body image concerns, eating disorders, and sexual difficulties. Seeking help from your GP or a psychologist will help overcome these problems.
For some women, medications are sometimes needed to help manage PCOS.
The oral contraceptive pill – The ‘pill’ can improve period symptoms and reduce androgen levels. In turn, this can reduce excess facial and body hair growth, improve acne and reduce scalp hair loss.
Progestin containing treatments e.g. MIRENA, Implanon, mini pill, Primolut. These treatments are sometimes used in women who have infrequent periods to prevent an abnormal build-up of the lining of the uterus (endometrial hyperplasia) and in the longer term prevent endometrial cancer.
Insulin-sensitising medications e.g. metformin. Insulin sensitising medications can help prevent weight gain, help stabilise blood glucose levels, reduce androgen levels and avoid progression to diabetes. They can also be used by women with PCOS with amenorrhoea (no periods) to initiate menstrual cycles (periods). Metformin works best in combination with lifestyle changes, and is not recommended as a substitute.
Anti-androgen medications e.g. spironolactone (Aldactone), cyproterone acetate (Androcur). These medications reduce androgen production and block the effects of androgens, so can reduce symptoms of androgen excess, such as excess facial and body hair growth, improve skin health (reduce acne) and reduce scalp hair loss. These drugs are teratogenic, which means they can cause birth defects if used while pregnant. For this reason, they are not suitable for use when pregnant or trying to get pregnant. When taking these medications, you must be using contraception.
Isoterinoin e.g. Roaccutane. This medication is used to treat severe acne. In Australia, isoterinoin can only be prescribed by a skin specialist. This medication is teratogenic, which means it can cause birth defects if used while pregnant. For this reason, it is not suitable for women who are pregnant or trying to get pregnant.
Fertility medications e.g. letrozole, clomiphene citrate. These medications can help restore periods and increase the chance of a successful pregnancy. IVF is an option for women who do not fall pregnant using these medications.