How do we treat polycystic ovary syndrome (PCOS)?
We have three main goals when treating PCOS:
- Keep the lining of the uterus healthy to prevent heavy and irregular periods, as well as other problems
- Reduce cosmetic signs such as acne or excess hair growth
- Screen for health issues related to PCOS, including high blood pressure, fatty liver disease, high cholesterol, diabetes, sleep disorders and depression
At Children's Colorado, our gynecologists provide patients with different treatment options for PCOS, including healthy lifestyle changes that teens can manage on their own. However, when lifestyle changes aren't enough, we can also prescribe medication that can be helpful.
For those who are overweight, or who are not overweight but are not exercising, the most important treatment is making lifestyle changes in diet and exercise. A 5% to 7% reduction of total body weight can improve periods in many teens with PCOS. Patients and their families using this treatment method have access to lifestyle specialists in our multidisciplinary clinic to help make these changes.
Our experts will discuss which medicines might be best suited for you or your child.
Birth control pills
For girls who have irregular periods, severe hair growth, acne or those who are sexually active, birth control pills can help.
These pills work by decreasing the amount of free testosterone in the body. Regular periods may start within the first month. It’s normal to have some irregular bleeding at first, but this will improve with time. It usually takes 3 months for acne to clear up and 6 months for decreases in hair growth.
Metformin helps girls who are overweight and have high insulin levels.
This medication can lower insulin levels and help the body use insulin more effectively. In 6 to 12 months, Metformin can help control periods, clear up acne and reduce hair growth. The most common side effect is nausea (upset stomach) but patients generally tolerate the drug well. Metformin improves the health of the ovaries and makes it easier to get pregnant. All young women who are sexually active should use birth control while taking Metformin.
Girls take this progesterone-only pill for 10 days to cause a period. It’s best for teens who have not had a period in more than 3 to 6 months.
Spironolactone blocks the action of testosterone. This medication minimizes hair growth and acne in 6 to 12 months. Taking birth control while on spironolactone is suggested due to the risks of birth defects while taking this medication.
Laser hair removal
Girls with light skin tone and dark hair growth often seek laser hair removal.
The dermatologist in our multidisciplinary clinic can discuss laser hair removal, if desired.
This over-the-counter product blocks the hair follicle from "seeing" testosterone and slows hair loss.
It's used for balding and the loss of hair at the front of the scalp. It takes 3 to 9 months to work and you can buy it at drug stores or grocery stores.
Vaniqa is a prescription cream that can decrease hair growth. Hair growth slows only while using the cream. It does not change hair growth over time.
Long-acting, progestin-only methods
Both the intrauterine device (IUD), Mirena, and the under-the-skin implant, Nexplanon, provide a steady, low-dose of progestin. Progestin is a hormonal medication that keeps the lining of the uterus healthy and reduces menstrual bleeding. The IUD works for 5 years and the implant works for 3 years. We can remove either method at any time.
Why choose Children's Colorado for polycystic ovary syndrome (PCOS) care?
The experts in the Department of Pediatric and Adolescent Gynecology place a strong emphasis on communicating with patients in a caring and sensitive way, whether you are a teen coming or the parent of a child we’re treating. We recognize that the teenage years can be a difficult time in a young woman's life and struggling with irregular periods and obesity as a result of PCOS can be very challenging. We not only provide expert medical treatment and considerate care but we can also help with the added stress that PCOS can cause.
Although PCOS is a common condition, the diagnosis and management of adolescents with PCOS is very different from adults. It requires the unique expertise and medical training in pediatric healthcare that all our doctors have. By combining the efforts of health professionals from different departments like gynecology, endocrinology, dermatology, psychology, lifestyle medicine and nutrition, we can help you or your child effectively manage this condition and move on to a healthier, happier life.
The multidisciplinary PCOS Clinic at Children's Colorado provides you or your child direct access to all these medical specialists at one location to ensure the best care possible and provide treatment tailored for you or your child’s individual needs.