PCOS Treatment

How is PCOS Diagnosed?

A gynaecologist usually diagnoses PCOS based on the patient's symptoms, menstrual history and physical examination. The doctor may ask about irregular or missed periods, acne, excess facial or body hair, weight changes and difficulty getting pregnant. Blood tests may be advised to check hormone levels and rule out other conditions with similar symptoms. An ultrasound scan may also be performed to examine the ovaries.

Most doctors diagnose PCOS using the Rotterdam criteria, which require any two of the following:

• Irregular or absent ovulation

• Signs or blood test evidence of excess male hormones (androgens)

• Polycystic ovaries seen on ultrasound

Other tests, such as blood sugar and cholesterol tests, may also be advised to check for metabolic problems commonly associated with PCOS.

How is PCOS Treated Based on Severity?

PCOS treatment depends on the severity of symptoms, associated health concerns, and individual treatment needs. The table below outlines the treatment approach based on the severity and condition:

PCOS Treatment Based on Symptoms

The treatment approach for PCOS depends on the symptoms experienced by the woman. The table below outlines the commonly recommended treatment options for different PCOS symptoms:

The treatment plan may change over time according to symptoms, overall health and whether the woman is planning a pregnancy.

Common Treatment Options for PCOS

PCOS treatment depends on the symptoms and whether pregnancy is planned. Doctors may recommend lifestyle changes, hormonal treatment or medicines to manage periods, excess hair growth, acne and other symptoms. Common treatments for PCOS include:

Other Treatments for PCOS

Women with PCOS who have difficulty getting pregnant may require fertility treatments if initial medicines do not help with ovulation. Gonadotropin injections may be used to stimulate ovulation, while in vitro fertilisation (IVF) may be considered when other fertility treatments are unsuccessful. In selected cases, laparoscopic ovarian drilling may be considered to stimulate ovulation.

Treatment is selected according to fertility needs, response to previous treatment and other factors affecting the chances of pregnancy.

Medicines for PCOS Treatment

Depending on a woman's symptoms and whether she is seeking pregnancy, medicines may be recommended. The most commonly utilised medications include the following:

Combined Oral Contraceptive Pills

These medications may help regulate a woman's menstruation, along with treating facial skin lesions or acne, as well as superfluous body hair. They include:

• Metformin: Helps improve insulin sensitivity and may support menstrual cycle regulation in some women.

• Letrozole: Often recommended to induce ovulation in women with PCOS who are trying to conceive.

• Clomiphene Citrate: May be prescribed to stimulate ovulation if pregnancy is desired.

• Progesterone: May be prescribed periodically to regulate menstrual cycles and protect the lining of the uterus in women who have infrequent periods.

• Anti-Androgen Medicines: Medicines such as spironolactone may help reduce excess hair growth in suitable patients.

Note: PCOS medicines should only be taken under the supervision of a gynaecologist. Some medicines require regular monitoring and are not suitable during pregnancy.

Ayurvedic and Alternative Treatments for PCOS

Some women may explore Ayurvedic or complementary approaches to support PCOS management. These should be used alongside, rather than as a replacement for, medical treatment. Some alternative treatment options for PCOS include:

• Yoga: May help support overall health and stress management.

• Meditation: May help reduce stress and support emotional well-being.

• Ayurvedic Treatment: Ayurvedic medicines and therapies taken under the guidance of a qualified AYUSH practitioner.

Note: Alternative treatments should only be considered after consulting a qualified healthcare practitioner.

Home Care for Managing PCOS

Simple lifestyle measures can support PCOS treatment and help manage symptoms. Some of these home care tips include:

• Eat a balanced diet with vegetables, fruits, whole grains and protein-rich foods.

• Exercise regularly.

• Maintain a healthy body weight.

• Follow a regular sleep schedule.

• Manage stress through yoga, meditation, or relaxation techniques.

• Keep track of menstrual cycles.

• Avoid smoking.

• Limit highly processed foods and foods high in added sugar.

• Take prescribed medicines regularly.

• Attend regular follow-up appointments.

• Monitor changes in periods and other PCOS symptoms.

Regular follow-ups are also important for monitoring blood sugar, blood pressure, cholesterol, and other health risks when advised by the doctor.

Latest Treatment for PCOS in India

PCOS treatment is increasingly focused on managing individual symptoms and reducing long-term metabolic risks. Letrozole is recommended as the first-line medicine for inducing ovulation in women with PCOS who experience infertility due to anovulation and have no other infertility factors.

Newer methods of management could also involve anti-obesity drugs like GLP-1 receptor agonists (e.g. Liraglutide, semaglutide) in appropriate individuals with obesity, on top of weight management. However, it should be prescribed under medical supervision, and pregnancy plans should be considered beforehand.

How Long Does PCOS Treatment Take?

The duration of PCOS treatment varies depending on the symptoms and the treatment prescribed. The table below provides approximate timelines depending on each treatment type:

PCOS is a long-term condition, so some women may require ongoing management even after their symptoms improve.

PCOS Treatment Side Effects

Most PCOS treatments can be used safely when prescribed and monitored appropriately. However, some treatments may cause side effects, including:

• Nausea or stomach discomfort

• Headache

• Changes in menstrual bleeding

• Breast tenderness

• Mood changes

• Dizziness

• Diarrhoea

• Risk of multiple pregnancy with some fertility medicines

• Ovarian hyperstimulation with certain fertility treatments

Lifestyle Changes for Managing PCOS

The following healthy habits may help manage PCOS symptoms and improve overall health:

• Help maintain a healthy body weight.

• Develop proper eating and nutrition skills.

• Become physically active.

• Decrease periods of inactivity.

• Get enough sleep.

• Reduce stress.

• Limit alcohol intake.

• Quit smoking.

• Take prescribed medicines regularly.

• Attend regular health check-ups.

• Monitor blood sugar, blood pressure and cholesterol when advised.

Factors That Can Worsen PCOS Symptoms

Certain lifestyle and health factors may make PCOS symptoms more difficult to manage. These include:

• Weight gain

• Physical inactivity

• Unhealthy eating habits

• Poor sleep

• High stress levels

• Smoking

• Excessive alcohol consumption

• Irregular use of prescribed medicines

PCOS Treatment Cost in India

PCOS treatment costs in India vary depending on the symptoms, treatment approach and duration of care. Monthly hormonal therapy may cost around ₹1,000 to ₹5,000, while ovulation induction for women planning pregnancy may cost ₹15,000 to ₹40,000. Laparoscopic ovarian drilling, when recommended, may cost approximately ₹40,000 to ₹80,000.

Moreover, diagnostic tests such as a pelvic ultrasound may cost ₹700 to ₹1,000, while blood tests may cost ₹400 to ₹800.

Note: Treatment costs are approximate and may vary depending on the city, hospital and treatment plan.