Tx of PCOS

• Hirsutism

  Excessive hair growth
• Local treatment for hirsutism

  1. Shaving

  2. Bleaching

  3. Waxing
• Eflornithine cream

  Inhibits hair growth but only effective in minority of cases
• Systemic treatment for hirsutism

  1. Estrogen (ex: OCP)

  2. Antiandrogens (ex: cyproterone acetate and flutamide)

  3. Spironolactone due to its antiandrogenic activity

  4. 5-ᾳ-reductase inhibitors (ex: finasteride)
• Menstrual disturbance

  Abnormal menstrual cycle
• Treatment for menstrual disturbance

  1. Cyclical estrogen/progesterone (also it improves hirsutism)

  2. Metformin (also it improves hyperinsulinemia & help weight loss)
• Infertility

  Inability to conceive
• Treatment for infertility

  1. Weight loss

  2. Ovulation induction (letrozole: aromatase inhibitor, clomiphene: selective estrogen receptor modulator)