Treatment for PCOS usually starts with lifestyle changes like weight loss, diet, and exercise.
Losing just 5 to 10 percent of your body weight can help regulate your menstrual cycle and improve PCOS symptoms. Weight loss can also improve cholesterol levels, lower insulin, and reduce heart disease and diabetes risks.
Any diet that helps you lose weight can help your condition. However, some diets may have advantages over others.
Studies comparing diets for PCOS have found that low-carbohydrate diets are effective for both weight loss and lowering insulin levels. A low glycemic index (low-GI) diet that gets most carbohydrates from fruits, vegetables, and whole grains helps regulate the menstrual cycle better than a regular weight loss diet.
A few studies have found that 30 minutes of moderate-intensity exercise at least three days a week can help women with PCOS lose weight. Losing weight with exercise also improves ovulation and insulin levels.
Exercise is even more beneficial when combined with a healthy diet. Diet plus exercise helps you lose more weight than either intervention alone, and it lowers your risks for diabetes and heart disease.
There is some evidence that acupuncture can help with improving PCOS, but more research is needed.
Common medical treatments
Birth control pills and other medicines can help regulate the menstrual cycle and treat PCOS symptoms like hair growth and acne.
Taking estrogen and progestin daily can restore a normal hormone balance, regulate ovulation, relieve symptoms like excess hair growth, and protect against endometrial cancer. These hormones come in a pill, patch, or vaginal ring.
Metformin (Glucophage, Fortamet) is a drug used to treat type 2 diabetes. It also treats PCOS by improving insulin levels.
One study found that taking metformin while making changes to diet and exercise improves weight loss, lowers blood sugar, and restores a normal menstrual cycle better than changes to diet and exercise alone (25).
Clomiphene (Clomid) is a fertility drug that can help women with PCOS get pregnant. However, it increases the risk for twins and other multiple births.
Hair removal medicines
A few treatments can help get rid of unwanted hair or stop it from growing. Eflornithine (Vaniqa) cream is a prescription drug that slows hair growth. Laser hair removal and electrolysis can get rid of unwanted hair on your face and body.
Surgery can be an option to improve fertility if other treatments don’t work. Ovarian drilling is a procedure that makes tiny holes in the ovary with a laser or thin heated needle to restore normal ovulation.
When to see a doctor
See your doctor if:
You’ve missed periods and you’re not pregnant.
You have symptoms of PCOS, such as hair growth on your face and body.
You’ve been trying to get pregnant for more than 12 months but haven’t been successful.
You have symptoms of diabetes, such as excessive thirst or hunger, blurred vision, or unexplained weight loss.
If you have PCOS, plan regular visits with your primary care doctor. You’ll need regular tests to check for diabetes, high blood pressure, and other possible complications.
The bottom line
PCOS can disrupt a woman’s menstrual cycles and make it harder to get pregnant. High levels of male hormones also lead to unwanted symptoms like hair growth on the face and body.
Lifestyle interventions are the first treatments doctors recommend for PCOS, and they often work well. Weight loss can treat PCOS symptoms and improve the odds of getting pregnant. Diet and aerobic exercise are two effective ways to lose weight.
Medicines are an option if lifestyle changes don’t work. Birth control pills and metformin can both restore more normal menstrual cycles and relieve PCOS symptoms.