While there is no cure for PCOS, with the right support you can greatly reduce the symptoms and long-term effects on your health. Because PCOS can have many symptoms, a range of treatments might be necessary to manage the condition well. The key to managing PCOS well is working in partnership with your healthcare team to find the best strategies for you. PCOS support groups can also be inviable sources of helpful information.
Managing PCOS with lifestyle
Healthy lifestyle has been shown to be the most effective approach to managing PCOS successfully and reducing the severity of symptoms. A healthy lifestyle includes eating a balanced and nutritious diet, being as active as possible, maintaining a healthy weight and minimising harmful habits such as smoking and excessive drinking.
Healthy eating
What you eat plays an important role in the management of PCOS. When it comes to achieving a healthy weight, eating a healthy diet is more effective than exercise alone.
A healthy diet helps not only with weight control, but also with reducing the risk of related health conditions such as type 2 diabetes and cardiovascular disease.
If you need to lose weight, the recommended way to do so is to reduce your overall food intake and eat a nutritionally balanced diet.3 It may take a bit of trial and error to find an approach that works best for you, with the focus being to find a plan that you can continue with in the long term.
Learn more about healthy eating.
Physical activity
Being physically active every day can help with PCOS symptoms and reduce the risk of developing related long-term health conditions. Try to include some kind of exercise in your daily routine. This could include moderate or vigorous aerobic exercise or resistance (using weights) exercise. Research has shown any type of regular exercise is effective in improving PCOS symptoms.
Learn more about exercise and physical activity.
Healthy weight
Having PCOS can mean you are more likely to gain weight and are at higher risk of developing unhealthy weight (up to 60% of those with PCOS are an unhealthy weight). This may be because the hormones involved in controlling appetite and hunger aren't regulated properly.
If you are overweight, even a small weight loss will help improve the symptoms of PCOS. Losing 5–10% of your body weight can have a significant impact on PCOS symptoms. Maintaining a healthy weight can help relieve PCOS-related symptoms and lead to more regular periods, less acne, a decrease in excess hair growth and improved mood and self-esteem.
Due to hormonal influences, losing weight if you have PCOS can be a challenge. However, losing weight may help to lower your blood glucose levels, improving the way your body uses insulin and helping your hormones reach normal levels. If you are struggling to find a weight loss plan that works for you, ask a dietitian for advice.
Learn more about healthy weight loss.
Managing PCOS with medicines
Medication alone has not been shown to be any better than healthy lifestyle changes in managing PCOS. You may be able to successfully manage your symptoms and long-term health risks without medical intervention.
There are a number of medications used to manage the different symptoms of PCOS, including for acne, excess hair growth, problems with your periods and fertility issues. Some medicines may help more than one symptom. PCOS affects everyone differently and your doctor will work out which medicines best meet your needs.
Sometimes excessive hair growth is best managed with both medical treatment and electrolysis or laser therapy. Your doctor can advise what’s best for you.
Contraceptive pill
The contraceptive pill is commonly prescribed to help regulate periods. The pill increases levels of sex hormone binding globulin (SHBG), which binds to testosterone in your blood. This reduces the activity of testosterone and therefore reduces symptoms related to higher levels of testosterone.
No one hormonal contraceptive is optimal in PCOS. Generally, you will be started on a lower dose preparation. Higher doses are used for severe symptoms.
Progestogen
You may be prescribed progestogen (a synthetic version of the female hormone progesterone) so you have regular periods. Examples of progestogen are medroxyprogesterone (Provera) and norethisterone (also called Primolut N).
Isotretinoin
Isotretinoin is used for severe acne that hasn’t been helped by other treatments. It works by reducing the amount of oil your skin produces and shrinking the oil glands in your skin. It is usually prescribed by a specialist doctor as it has many side effects. It should not be used in pregnancy or if you become pregnant as there is a high risk of permanent damage to the unborn baby. Read more about isotretinoin and acne treatments.
Metformin
Metformin is commonly used in people with type 2 diabetes, but can also can help to reduce some symptoms of PCOS. It helps your body make better use of the insulin it produces. It can help with weight loss and blood pressure. It can also often restore your menstrual cycle, as well as helping control excess body hair caused by high testosterone levels. Common side effects are nausea (feeling sick) and tummy upset.
Women with PCOS have a higher chance of getting type 2 diabetes, but taking metformin can help delay or prevent this. Metformin should be used together with increased exercise and a nutritious diet, not as a replacement for lifestyle changes. Read more about metformin for PCOS.
Spironolactone
Spironolactone used to reduce male-pattern hair growth and acne. It can reduce androgen levels. Up to 80% of women with PCOS see a reduction in excess hair growth when using spironolactone. It can take up to 6 months of daily use for it to become effective. It is a diuretic (water tablet) so it gets rid of excess salt and water in your body. Common side effects are nausea, vomiting, headaches and, rarely, rashes. Read more about spironolactone.
Managing your emotional wellbeing
PCOS can be a challenging condition to live with and it can affect your mental wellbeing. This may be due to a combination of hormonal influences and dealing with the symptoms of PCOS. It’s not uncommon to experience low self-esteem, poor self-image, anxiety and depression – all of which can affect your overall quality of life.
Managing fertility
Having PCOS does not mean you can't get pregnant. PCOS is one of the most common, but treatable, causes of infertility. If you have PCOS, the hormonal imbalance interferes with the growth and release of eggs from your ovaries (ovulation). If you don't ovulate, you can't get pregnant. Your doctor or a fertility specialist can talk with you about ways to help you ovulate and to raise your chance of getting pregnant.
Managing excess hair
Sometimes excessive hair growth is best managed with both medical treatment and electrolysis or laser therapy. Your doctor can advise what’s best for you.