The management of PCOS depends on the presenting clinical features and is modified as per the requirements of the patient. Lifestyle modification, weight loss, stress management, and physical exercise are important for all the patients, and they play a tremendous role in the improvement of the hormonal imbalance. Antiandrogen drugs are used to treat unwanted hair and acne along with estrogen-containing hormone preparations. In a few patients, they are used along with drugs like Metformin, which improve insulin sensitivity. In patients who wish to conceive, they are treated with ovulation induction drugs along with possibly metformin. Patients with significant hirsutism may benefit from local therapies like ointments or laser methods. The dose and drugs are reviewed every two months to ensure that they are still appropriate for the patient's needs.
The diagnosis of PCOS is based on the performance of a few hormonal tests in a blood sample and an abdominal scan to look at the ovaries. It is important to understand that all the patients may not have the typical clinical features and hormonal disturbances as described for the diagnosis. Patients may have a mix and match of a few symptoms and signs, and this helps in sub categorizing into different groups of PCOS. The traditional definition includes the presence of any two of the following to diagnose PCOS (irregular menses, clinical/biochemical excess of male sex hormone, and polycystic ovaries on the sonography scan).
A healthy, balanced diet is always beneficial for PCOS. The diet should be rich in green vegetables, fruits, whole grains, pulses, and healthy fats like unrefined vegetable oils, nuts, and seeds. Patients with PCOS who follow a low-GI ( glycemic index) diet tend to have a better quality of life and more regular periods.
In PCOS, being overweight or weight gain is a common symptom. So, it is advised to maintain an ideal body weight to get rid of PCOS. Daily physical activity (Yoga, meditation, cardio, muscle strengthening) should be part of a healthy lifestyle along with a balanced diet plan.
Highly processed foods, refined flour (maida), chocolates, high-salty foods, ice creams, and deep-fried items (chips, wafers, namkeen) should be restricted in the diet for PCOS.
Based on the clinical status of every individual, follow-up with the dietician is helpful for treating PCOS. Although twice a month, a patient should follow up with the dietician in the initial stage of diagnosis.