As you know poly cystic ovaries and infertility is difficult to control in many cases. Sometimes prescribing traditional hormonal drugs and metformin in over weight female with NIDDM is not effective. What is the best therapeutic agents to control these patients?
Dear Colleague, the therapeutic approach to the PCOS patient varies according to the target. If the patient is craving for pregnancy and does not ovulate clomiphene citrate represents the first therapeutic choice. In case the patient does not currently want pregnancy, the therapeutic orientation should be as follows: Food Diet aerobic physical activity Myinositol and / or metformin Contraceptive pill. I have published a lot about the subject and my studies can be found on pubmed. do not hesitate to contact me for any other information Vittorio Unfer
PCOS therapy must be phenotype driven. I consider pregnancy wish as a particular case and I prefer letrozole combined or not with low dosis of FSH.
In the presence of biochemical hyperandrogenism the aim is to increase SHBG, inhibit LH pulsatility and diminish free testosterone. I do prefer EE 35ug combined with 2 mg cyproterone acetate. If necessary, I increase CPA
in 25 mg for 10 days each month. In the presence of glucose intolerance or insulin resistance I have experience only with metformin. In the presence of obesity I use a COC containg drospirenone associated with diet, exercise, and orlistat. If possible 1.8 mg day of liraglutide. In the presence of various phenotypes a combined therapy is indicated.For dislipidemia statins should be used.
There is some evidence to suggest that acupuncture is a useful adjunct to medication.