Questions to Ask Your Healthcare Provider About PCOS

Do I Need To Take Birth Control Pills?

Hormonal contraceptives are frequently prescribed to treat PCOS. These medications can restore or normalize menstruation and also prevent or alleviate common symptoms such as acne and hirsutism (excess hair growth). They can also prevent endometrial cancer in patients with PCOS without menses (no period).

Some people may not be comfortable taking birth control pills. Common reasons include a history of side effects caused by oral contraceptives, religious beliefs, social misconceptions like weight gain and infertility, or the desire to balance hormones in a more natural way.

If you fall into this camp for any reason, you will not have to take birth control pills to treat your PCOS. There are other options. In particular, medications that help the body process insulin, such as metformin (also available as Glucophage Fortament, Riomet, and other brand names) and Actos (pioglitazone) are often prescribed, along with weight loss and other lifestyle changes.

If I’m Insulin-Resistant, How Will That Affect My Treatment?

Insulin resistance occurs when the body is unable to use the insulin it produces to lower blood sugar levels. It's a common issue for people with PCOS. For this reason, your healthcare provider will likely conduct a blood test for insulin resistance as part of your work up for PCOS.

If you're diagnosed with insulin resistance, a medication such as metformin can help your body use insulin properly and reduce your risk of diabetes. Research has found that insulin-lowering medications also can help to promote ovulation in women with PCOS.

Should I Lose Weight?

Weight loss is a key element of PCOS treatment. Losing weight helps to reduce insulin levels as well as levels of androgens—male hormones that often are elevated in people with PCOS.

Losing weight also may lower the risk of sleep apnea, which is associated with both extra weight and high levels of androgens, along with other PCOS symptoms, although it won't eliminate them entirely.

Because insulin resistance is typically partially responsible for extra pounds, it can be especially challenging for women with PCOS to shed them. Ask your healthcare provider for guidance. Besides eating fewer calories and getting more exercise, you may do well to work with a nutritionist or dietitian and/or join a support group.

How Can I Lower the Risk of Complications?

PCOS is associated with several potentially serious diseases and conditions. They include heart disease, diabetes, endometrial cancer, and metabolic syndrome.

You can lower your risk of complications from PCOS by strictly adhering to the treatment plan your healthcare provider prescribes for you. Losing weight, eating a diet rich in vegetables and some fruits (as too much fructose can exacerbate insulin resistance), and getting plenty of physical activity can also help. In some cases, hormonal therapy can help reduce the risk of endometrial cancer.

How Will PCOS Affect My Fertility?

Up to 80% of people with PCOS have trouble getting pregnant. If you're among them or are worried your PCOS might cause you to have trouble conceiving in the future, bring this up with your healthcare provider. There are a number of treatment options, including eating a diet that's rich in antioxidants and includes moderate amounts of unprocessed carbohydrates.

Increasing physical activity can help as well. And there's some research to suggest that vitamin D supplementation may help some women with PCOS who are experiencing infertility.

If lifestyle modifications aren't enough, medication or hormonal treatments usually are tried next, followed by procedures such as assisted reproductive technology. Rest assured, research shows that most women who face infertility issues due to PCOS go on to have healthy pregnancies and babies.