Therapeutic Options in Polycystic Ovary Syndrome

The 2007 document outlines various treatment strategies for polycystic ovary syndrome (PCOS), emphasizing symptom management and long-term health risk monitoring. For menstrual irregularities, oral contraceptives or progestogen therapy are recommended, while weight loss and metformin are beneficial for improving symptoms and insulin resistance. Anti-androgenic drugs like spironolactone, flutamide, and finasteride are effective for hirsutism but carry risks such as teratogenicity and hepatotoxicity. Cyproterone acetate combined with oral contraceptives can be used for short-term hirsutism management, and eflornithine hydrochloride cream is mentioned for facial hair. In cases of anovulatory infertility, clomiphene citrate is the first-line treatment, with metformin and letrozole as additional options, though letrozole's safety is still under review. For those resistant to clomiphene, gonadotrophin therapy or laparoscopic ovarian diathermy are alternatives. The document stresses the importance of individualized treatment plans and lifestyle changes to manage PCOS effectively.