Insulin resistance and obesity can often be the inciting factors for PCOS development. One of the first steps in management involves weight loss, as it may be curative.
Oral contraceptives are very helpful in treating acne and hirsutism caused by increased androgens. Contraceptives have estrogen, which decreases LH and increases steroid hormone binding-globulin, leading to decreased free testosterone.
Clomiphene citrate is used to help treat infertility. It works by blocking the negative feedback of circulating estrogen, increasing FSH and LH release, in order to stimulate ovulation.
Anti-androgen medications block the action of male hormones that are believed to contribute to acne and the growth of unwanted facial and body hair.
Cyclic progesterone therapy is given for endometrial protection in patients with PCOS. As unopposed estrogen is a huge risk factor for endometrial cancer, cyclic progesterone helps to antagonize endometrial proliferation.
Metformin can be a very helpful medication to women with PCOS. It works to increase insulin sensitivity, which decreases insulin levels. Eventually, this leads to decreased testosterone and enables the LH surge necessary for ovulation.
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