Patient information from BMJ

Polycystic ovary syndrome: what treatments work?

Last published:Feb 08, 2024

Polycystic ovary syndrome is a common hormone problem that affects women. It can make your menstrual periods less regular, and you may have trouble getting pregnant. But there are treatments available and things you can do yourself that may help. 

What is polycystic ovary syndrome?

If you are diagnosed with polycystic ovary syndrome (PCOS) it means that your hormones are not in balance. The hormones made by your ovaries are the ones most affected. They are called oestrogens, androgens, and progesterone.

These hormones affect a lot of things that go on in your body, including when you have your period, when your ovaries release eggs (ovulation), how hair grows on your face and body, and the condition of your skin. 

What treatments work?

If you have PCOS you will be encouraged to have a healthy diet and exercise regularly. This will help your health and wellbeing. But specific treatment for PCOS depends on what symptoms you get and whether or not you want to get pregnant.

If you are having trouble getting pregnant, there are fertility treatments that may help. Ask for our leaflet, Fertility problems: what treatments work? for more information about this.

Losing weight

If you are overweight or obese, one of the first things that your doctor will suggest is losing weight. Losing some weight, even if it's not much, may help your body to ovulate normally. This may help with getting pregnant. However, it may not make much difference for unwanted hair or acne. 

No single diet has been shown to be best for helping women with PCOS lose weight. The key is to find a healthy diet you can stick to. 

Hair removal

If your main problem is unwanted hair on your face and body, you may have tried different methods of hair removal.

Shaving or using depilatory creams removes hair above the root, but it grows back after a day or two. Waxing pulls hair out by the roots, so it takes a little longer for the hair to grow back. These treatments can be done at home or in a beauty clinic.

Electrolysis aims to damage the root of the hair, so it doesn't grow back at all. Laser treatments slow down the growth of hair. After about four treatments, the hair may stop coming back. But both treatments can be expensive and time-consuming, and some women find them painful.

If you decide to have this treatment, make sure the clinic you choose is properly registered.

A cream called eflornithine is another option to help with unwanted hair. It works by slowing down hair growth on the face. But this is not available over the counter so you will need to speak to your doctor about it.

Hair removal options are usually recommended along with medical treatments to see the best effect. These include the contraceptive pill and anti-androgen drugs. You can read more about these options below.

Medicines (if you want to get pregnant)

If weight loss hasn’t worked for you, your doctor will probably recommend starting medicine to improve your chances of getting pregnant.

One example is metformin. Your doctor may recommend this if you are overweight or obese.

Metformin is also used to treat people with diabetes. It helps control the levels of sugar in your blood. But it also seems to help some women with PCOS. You're likely to have more regular periods if you take metformin. This might make it easier for you to get pregnant.

Some women who take metformin have side effects. But these are mostly mild. You may feel some nausea or heartburn, or get diarrhoea.If you are of a healthy weight, your doctor will likely suggest a medicine called letrozole or clomifene instead. These are treatments that try to increase ovulation and improve your chances of getting pregnant.

Other treatments can help stimulate your ovaries, so they are more likely to release eggs. We have more information about these in our fertility treatment leaflet (Fertility problems: what treatments work?).

Medicines (if you don't want to get pregnant)

If you don't want to get pregnant and you are having problems with irregular periods, unwanted hair, or acne, your doctor may suggest you take the contraceptive pill.

The pill can sometimes cause minor side effects like nausea, mood swings, and headaches in the first few months. Some women may also experience spotting. All women taking the combined oestrogen and progestogen pill have a slightly increased risk of breast cancer and of getting a blood clot in their veins (deep vein thrombosis). If you are concerned about any risks or side effects, speak to your doctor.

If you've tried taking the pill and it hasn't helped, or if you have a lot of unwanted hair, your doctor may suggest anti-androgen drugs. These reduce the amount of androgen hormones in your body and may help reduce unwanted hair. But they will only be prescribed by a specialist.

You have to be careful not to get pregnant while taking these drugs, as they can harm your unborn baby. You'll need to take these drugs for a long time (at least six months) to see if they work. If you stop taking them, the hair will start growing back again. 

Anti-androgen drugs have side effects which can be serious. You should discuss them with your doctor before you start taking them.

Your doctor may also suggest metformin, sometimes along with either the pill or an anti-androgen drug.

For more background information on PCOS see our leaflet Polycystic ovary syndrome: what is it?