What is the best treatment for PCOS?

Polycystic ovary syndrome (PCOS) is a complex condition that affects hormone levels, ovulation, and metabolism, with symptoms ranging from irregular periods and excessive hair growth to difficulty conceiving. The best treatment for PCOS depends on the individual's symptoms, health goals and whether they are looking to manage the condition or improve fertility.

Lifestyle changes: The foundation of PCOS management

For many, lifestyle changes are a cornerstone of PCOS treatment. Symptoms can be significantly improved by a balanced diet, regular exercise and weight management. Even modest weight loss (5 to 10 per cent of body weight) can help regulate periods, reduce insulin resistance and improve fertility.

Hormonal treatments: Regulating cycles and managing symptoms

Hormonal contraceptives, such as the combined pill, are commonly prescribed to regulate menstrual cycles and reduce symptoms like acne and excess hair growth. Other options include progestogen-only pills or a Mirena coil to protect the womb lining if contraception isn’t required.

Managing insulin resistance: Metformin

Metformin is often prescribed to women with PCOS who have insulin resistance or prediabetes. This medication helps improve how the body processes sugar and may support ovulation and weight loss in some patients.

Ovulation induction: For women trying to conceive

For those looking to improve fertility, ovulation induction medications like clomifene or letrozole can be effective. These drugs stimulate ovulation and increase the chance of conception. For women who do not respond to these medications, gonadotropins or IVF (in vitro fertilisation) may be recommended.

Cosmetic treatments: Addressing physical PCOS symptoms

Excess hair growth or hair loss can be distressing for women with PCOS. Treatments like laser hair removal, electrolysis, or topical medications such as eflornithine can help. Dermatological treatments may be used for acne.

Holistic approaches and newer options

Acupuncture and mindfulness-based therapies can also provide relief for stress associated with PCOS. An emerging treatment is inositol, which comes in supplement form, and it’s said to improve insulin sensitivity and restore hormonal balance. However, it’s important to remember that inositol isn’t an established evidence-based intervention, and it’s advised to take precaution and seek specialist advice before going ahead

A personalised approach is key

There’s no one-size-fits-all treatment for PCOS. Managing this condition often involves addressing symptoms and underlying issues through a combination of medical interventions, lifestyle changes, and emotional support. Arranging a consultation with an endocrinologist, gynaecologist or fertility specialist can help tailor a treatment plan to suit individual needs.