What therapies alleviate symptoms of polycystic ovary syndrome?

Abstract

Q: What therapies alleviate symptoms of polycystic ovary syndrome? A: Treatment of polycystic ovary syndrome (PCOS) in women not actively seeking to become pregnant is symptom-specific. Lifestyle modification (LSM) reduces body weight by 3.5 kg (strength of recommendation [SOR]: A, meta-analysis) and metformin reduces it by 3 kg (SOR B, cohort trial). LSM may be better tolerated; adding metformin to LSM doesn’t lead to additional weight loss (SOR: B, randomized controlled trial [RCT]). Spironolactone improves hirsutism scores by an absolute 8% to 22% (SOR: A, multiple RCTs); adding metformin to spironolactone improves Ferriman-Gallwey (FG) hirsutism scores an additional absolute 1.4% (SOR: B, RCT). Oral contraceptive pills (OCPs) are 12 times more likely to result in complete menstrual regularity than metformin (SOR: A, meta-analysis). Combining OCPs with metformin improves hirsutism scores by 8% over using an OCP alone (SOR: A, metaanalysis).