Polycystic ovarian syndrome (PCOS) is a common disorder of the endocrine system in women. Most women with PCOS grow many small cysts on their ovaries. Although the cysts themselves are not harmful, they can lead to hormone imbalances. Symptoms of PCOS include irregular periods, acne, weight gain and/or trouble losing weight, excess hair growth on the face and body, thinning hair on the scalp, and infertility. Women with PCOS may also develop insulin resistance, leading eventually to diabetes or heart disease if left untreated.
For women with PCOS, fertility issues are due to irregular ovulation. The oral medication clomiphene (brand name: Clomid or Serophene) is the most common treatment. It is typically the first medication tried because it has a long history of effectiveness and can be taken orally, rather than by injection. A typical course of clomiphene lasts up to three to six months.
Metformin (brand name: Glucophage), a medication normally used to treat type 2 diabetes, has also been found to help with PCOS symptoms, including regulating ovulation, and can be used either alone or with clomiphene when clomiphene alone is unsuccessful. A third option for inducing ovulation is letrozole (brand name: Femara). Letrozole has been shown to be as effective as clomiphene in inducing ovulation, but some studies suggest an increased risk of birth defects.
If oral medications are not effective, injectable hormones are another possible option for women with PCOS.