| Treatments, herbs and natural products |
Oral contraceptives are the most commonly used treatment for establishing normal menstrual periods in women with PCOS. Also because women with PCOS can occasionally ovulate, oral contraceptives can provide the added benefit of preventing pregnancy. Although the pill results in monthly menstrual periods, this does not mean that the PCOS is "cured" because irregular cycles return when the pill is stopped.
Medications are also effective for hirsutism, scalp hairloss and acne in women with PCOS. Oral contraceptives decrease the body's production of androgens, and antiandrogen drugs (such as spironolactone) decrease the effect of androgens.
Obesity and insulin abnormalities are common among women with PCOS. Treatment of both conditions can decrease the ovary's production of androgens and reestablish the body's normal hormone balance. The end result is that some symptoms of PCOS improve.
Insulin-lowering drugs are an option for treating the insulin abnormalities associated with PCOS. This class of drugs includes metfromin (Glucophage), a drug that is prescribed primarily for the treatment of diabetes. There are also other experimental drugs such as D-chiro-inositol that are now being tested in PCOS. Metfromin for women with PCOS has been receiving much attention in magazines, on television, and on the internet. In some women with PCOS, metformin is a reasonable alternative. In preliminary studies, metformin helps restore normal menstrual cycles in approximately 50 percent of women with PCOS. Blood androgen levels sometimes decrease, but there may not be much improvement in hirsutism or acne. In addition, metformin does not provide contraception. In fact, it might stimulate ovulation, so women must be careful in their use of this drug if they don't want to become pregnant. Because metformin often stimulates ovulation, it is sometimes used to help women with PCOS who are trying to conceive.
If a woman with PCOS and her partner are having difficulty getting pregnant, a doctor usually first recommends that both individuals have thorough medical exams to determine the exact cause of infertility. These exams may include tests of the fallopian tubes in the woman and a semen analysis in the man. If tests determine that lack of ovulation due to PCOS is the cause of infirtility, a number of options are available to promote ovulation and pregnancy. It is important to know that all of these options work best for women who are not obese. However, even a modest amount of weight loss can make these treatments more effective.
Clomiphene citrate - The first line of treatment is the fertility drug clomiphene citrate, which wtimulates the ovaries to release one or more eggs. Clomiphene triggers ovulation in about 80 percent of women with PCOS, and about 50 percent of these women will actually become pregnant. In women taking clomiphene, ovulation can be confirmed by blood and urine tests or by measurement of body temperature. If the original dose of clomiphene doesn't trigger ovulation, a woman's doctor may prescribe a higher dose. Several studies have shown that the insulin-sensitizing drug, metformin, increases the effectiveness of clomiphene in producing ovulation. However, it is unknown if this drug is safe during pregnancy.
Ovarian surgery - Surgery is only used as a last measure for the treatment of infirtility in women with PCOS, but can be effective in some women who do not respond to medical treatment. Today, surgery is usually performed through a laparoscope (a thin, lighted tube). Instruments advanced through the laparoscope are used to mechanically or thermally damage the ovary. This damage likely decreases androgen levels in the ovary and alters other hormone levels in the body, tiggering the maturation and release of eggs. Women with PCOS have an 80 percent to 87 percent chance of becoming pregnant after laparoscopic surgery. Furthermore, surgery usually returns normal menstrual cycles for a prolonged period of time. Women considering surgery should discuss the potential benefits and risks with their doctor. Surgery to induce ovulation is typically less effective in overweight women. The procedure can lead to the formation of adhesions (attachments of abdominal contents to each other or to the abdominal wall), wasting the ovary, injury to surrounding tissues, and infection. Although the long-term effects of ovarian surgery are still being evaluated, studies suggest that the procedure may also lead to early menopause.
Below are some herbs that can be used for treating PCOS. I found these during my research. The ones I've used myself are Black Cohosh, Chaste tree and Saw palmetto. I didn't find Black Cohosh to be of any help. I did find Chaste tree helpful and Saw palmetto was very helpful for my oily skin. As for dosage, I took the recommended dosage on the bottle and I bought them from a health store. However I recommend you check with your health store worker or a herbalist before you embark on using herbs as everyones reaction could be different and I'm only speaking from my own experience. I have no knowledge of herbs whatsoever!
Black Cohosh - may have anti-androgenic effect and may lower LH levels
Blueberries - may normalise bloodsugar levels
Chaste tree - for irregular menstruation and pain with periods. This herb is well tolerated and excellent for balancing hormones
Saw palmetto - this herb is well known for it's ability to inhibit the conversion of testostorone into DHT
Devils club - this herb may be useful as a tonic to regulate how the body responds to stress. This is important as stress can lead to insulin resistance
To follow shortly.
There are several things that an individual can do if they have a tendency towards developing some or all of the elements of PCOS. Much of this involves lifestyle changes to ensure that your weight is kept within normal limits (BMI between 19 and 25). In addition, because there is a likelyhood of developing diabetes in later life and a slightly higher risk of heart didease, low-fat and low-sugar options should be considered when making choices about what to eat or to drink. Weight loss, or maintaining weight below a certain level, will have the short-term benefit of increasing the likelihood of successful treatment and the long-term benefits of reducing the risk of diabetes and heart disease (Galtier-Dereure et al, 1997).