What are the pharmacologic treatments for polycystic ovarian syndrome (PCOS)?

Updated: Sep 19, 2019
  • Author: Richard Scott Lucidi, MD, FACOG; Chief Editor: Richard Scott Lucidi, MD, FACOG  more...
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Pharmacologic treatments are reserved for so-called metabolic derangements, such as anovulation, hirsutism, and menstrual irregularities. First-line medical therapy usually consists of an oral contraceptive to induce regular menses.

If symptoms such as hirsutism are not sufficiently alleviated, an androgen-blocking agent may be added. First-line treatment for ovulation induction when fertility is desired are letrozole or clomiphene citrate. [3, 4, 6]

  • Medications used in the management of PCOS include the following:

  • Oral contraceptive agents (eg, ethinyl estradiol, medroxyprogesterone)

  • Antiandrogens (eg, spironolactone, leuprolide, finasteride)

  • Hypoglycemic agents (eg, metformin, insulin)

  • Selective estrogen receptor modulators (eg, clomiphene citrate)

  • Topical hair-removal agents (eg, eflornithine)

  • Topical acne agents (eg, benzoyl peroxide, tretinoin topical cream (0.02–0.1%)/gel (0.01–0.1%)/solution (0.05%), adapalene topical cream (0.1%)/gel (0.1%, 0.3%)/solution (0.1%), erythromycin topical 2%, clindamycin topical 1%, sodium sulfacetamide topical 10%)

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