Living With PCOS

NHS

Polycystic ovary syndrome (PCOS) cannot be cured, but the symptoms can be managed. Treatment options can vary because someone with PCOS may experience a range of symptoms, or just 1. The main treatment options are discussed in more detail below.

Lifestyle changes

In overweight women, the symptoms and overall risk of developing long-term health problems from PCOS can be greatly improved by losing excess weight. Weight loss of just 5% can lead to a significant improvement in PCOS.

You can find out whether you're a healthy weight by calculating your body mass index (BMI), which is a measurement of your weight in relation to your height.

A normal BMI is between 18.5 and 24.9. Use the BMI healthy weight calculator to work out whether your BMI is in the healthy range.

You can lose weight by exercising regularly and eating a healthy, balanced diet. Your diet should include plenty of fruit and vegetables, (at least 5 portions a day), whole foods (such as wholemeal bread, wholegrain cereals and brown rice), lean meats, fish and chicken. Your GP may be able to refer you to a dietitian if you need specific dietary advice.

Medicines

A number of medicines are available to treat different symptoms associated with PCOS.

Irregular or absent periods

The contraceptive pill may be recommended to induce regular periods, or periods may be induced using an intermittent course of progestogen tablets (which are usually given every 3 to 4 months, but can be given monthly).

This will also reduce the long-term risk of developing cancer of the womb lining (endometrial cancer) associated with not having regular periods.

Other hormonal methods of contraception, such as an intrauterine system (IUS), will also reduce this risk by keeping the womb lining thin, but they may not cause periods.

Fertility problems

A medicine called clomifene may be the first treatment recommended for women with PCOS who are trying to get pregnant. Clomifene encourages the monthly release of an egg from the ovaries (ovulation).

If clomifene is unsuccessful in encouraging ovulation, another medicine called metformin may be recommended. 

Metformin is often used to treat type 2 diabetes, but it can also lower insulin and blood sugar levels in women with PCOS.

Metformin is not licensed for treating PCOS in the UK, but because many women with PCOS have insulin resistance, it can be used "off-label" in certain circumstances to encourage fertility and control the symptoms of PCOS.

Letrozole is sometimes used to stimulate ovulation instead of clomifene. This medicine can also be used for treating breast cancer. Doctors sometimes use an unlicensed medicine if they think it's likely to be effective and the benefits of treatment outweigh any associated risks.

If you're unable to get pregnant despite taking oral medicines, a different type of medicine called gonadotrophins may be recommended. These are given by injection. There's a higher risk that they may overstimulate your ovaries and lead to multiple pregnancies.

Unwanted hair growth and hair loss

The combined oral contraceptive pill is usually used to treat excessive hair growth (hirsutism) and hair loss (alopecia). A cream called eflornithine can also be used to slow down the growth of unwanted facial hair.

This cream does not remove hair or cure unwanted facial hair, so you may wish to use it alongside a hair removal product. Improvement may be seen 4 to 8 weeks after treatment with this medicine.

If you have unwanted hair growth, you may also want to remove the excess hair by using methods such as plucking, shaving, threading, creams or laser removal. 

Laser removal of facial hair may be available on the NHS in some parts of the UK. Sometimes medicines called anti-androgens may also be offered for excessive hair growth.

Other symptoms

Medicines can also be used to treat some of the other problems associated with PCOS, including:

  • weight-loss medicine, such as orlistat, if you're overweight
  • cholesterol-lowering medicine (statins) if you have high levels of cholesterol in your blood
  • acne treatments

IVF treatment

If you have PCOS and medicines do not help you to get pregnant, you may be offered in vitro fertilisation (IVF) treatment. This involves eggs being collected from the ovaries and fertilised outside the womb. The fertilised egg or eggs are then placed back into the womb. IVF treatment increased the chance of having twins or triplets if you have PCOS.

Surgery

A minor surgical procedure called laparoscopic ovarian drilling (LOD) may be a treatment option for fertility problems associated with PCOS that do not respond to medicine.

Under general anaesthetic, your doctor will make a small cut in your lower tummy and pass a long, thin microscope called a laparoscope through into your abdomen.

The ovaries will then be surgically treated using heat or a laser to destroy the tissue that's producing androgens (male hormones). LOD has been found to lower levels of testosterone and luteinising hormone (LH), and raise levels of follicle-stimulating hormone (FSH). This corrects your hormone imbalance and can restore the normal function of your ovaries.

Useful resources

This Teachers' Maternity Leave Scheme has been updated to reflect the rules concerning...
EA is committed to ensuring that all individuals are treated fairly and with dignity and...
This programme is a six week training programme for groups of adults and focuses on...
The Menopause Project is an education and research project between Informing Choices NI...
We all have good and bad days but what and when we eat can influence our mood, energy,...
There are a number of health campaigns throughout the year to raise awareness of...
Around one in five women will experience a mental health issue during pregnancy or within...
Cancer Focus NI, Keeping Well vans are mobile drop-in units which bring health checks,...
This includes: Raising awareness of depression and Aware NI services at a wide range of...
We are delighted to provide this FREE digital toolkit. Designed in partnership with the...
Affected by breast cancer? Join this group to share experiences and ask questions to...
Cancer Focus NI can provide a wide range of presentations to meet the needs of your...
Sometimes when faced with an unplanned or crisis pregnancy it is difficult to discuss it...
Guided meditations
Learn to manage negative thoughts and look at problems differently
Food diary, exercise tracker and diet coach
Support hub for mothers
Track your treatment and wellbeing
Pregnancy and guidance for after birth
Active 10 is a free and easy to use walking app that tracks your walking and shows you...
It’s an easy to follow programme known the world over, and perfect for those new to...
Guided meditations
Handle stress and anxiety on the go
Support for breast cancer
This short test will help you understand how heavy your periods are, and point you in the right direction for treatment options.
Your Mind Plan offers practical ideas and advice to help you boost and maintain your mental wellbeing. Answer the quick 5-question quiz and the Every Mind Matters widget will give you 5 tailored actions to help you feel more in control, improve your sleep, deal with stress and anxiety, and boost your mood – as well as the option to easily swap any actions and to save the whole plan via email.

Articles & Videos

Helplines & Web Chats

Informing Choices NI - Helpline
Royal Osteoporosis Society - Helpline
Macmillan - Forum
Macmillan - Ask an expert
Women's Aid - Forum
Association for Post-Natal Illness Helpline
Women's Aid - Domestic abuse helpline