Your doctor should be your first port of call if you suspect you have PCOS. Work with them to build up a good relationship, and remember that your GP can only help you if you talk to them openly about all your symptoms, no matter how embarrassing these may seem.
Book a double appointment so you have plenty of time to talk, and perhaps take along a friend or relative for support. Write a PCOS Diary, including notes on your symptoms, frequency of periods and any particular concerns you have. Stay calm, describe your symptoms and discuss the options.
If you have not yet been diagnosed, your doctor should refer you for blood tests and an ultrasound scan to rule out other conditions which could be causing the symptoms, such as thyroid problems.
Once you are diagnosed, there are many treatment options available, including:
- The contraceptive pill for regulating periods – Dianette or Yasmin contain anti-androgens which improve acne, hirsutism and alopecia
- Metformin (Glucophage), pioglitazone (Actos) or rosiglitazone (Avandia) for improving insulin resistance and menstrual cycles (and hence fertility)
- Vaniqa cream for reducing facial hair growth; Androcur, spironolcatone, flutamide and finasteride for excess hair; laser hair reduction (which may be available on the NHS)
- Clomiphene citrate (Clomid), gonadotropins or ovarian laproscopy (a type of surgery) for restoring ovulation and fertility. IVF may also be an option
- Orlistat (Xenical) and sibutramine (Reductil) for weight control
- Statins (eg simvastatin) to improve blood fats
You may be referred to a specialist, such as an endocrinologist, obstetrician, gynaecologist or dietician, and your doctor should be happy to discuss regular screening for risk factors such as endometrial cancer, diabetes and heart disease. If at any time you are unhappy with what is offered, remember that you have the right to a second opinion. If your doctor is really unhelpful, change your doctor.
Bear in mind that there is no ‘magic bullet’ cure for PCOS. It responds best to a ‘whole body’ approach, which means that whatever medication you may decide to take, you also need to make some lifestyle changes, including improving your diet and activity levels. Ask for your doctor’s advice on nutrition, weight control and exercise, and use this action plan to help you.
