Even though controversies surrounding the polycystic ovary syndrome are not yet close to be solved, its clinical manifestations are well known—insulin resistance and obesity, hirsutism, irregular and anovulatory menstrual cycles. The treatment of polycystic ovarian syndrome (PCOS) is mainly symptomatic as its etiology is not yet clear. Lifestyle changes are the primary therapy in overweight and obese women with PCOS. According to majority of the studies, lifestyle changes are the most effective form of treatment not only for weight loss but also for the improvement of insulin sensitivity, decreasing incidence of metabolic syndrome and type 2 diabetes. Studies also show that weight loss has fertility benefits by restoring ovulatory cycles. Although initial studies researching pharmacologic treatment were showing excellent results concerning the weight loss, maintenance of weight loss and reduction of cardiovascular risks, some of these drugs were in the end, has proven to actually increase the risk for cardiovascular events and were removed from the market. Bariatric surgery has been demonstrated to improve or even cure type 2 diabetes, hypertension, hyperlipidemia, and obstructive sleep apnea. More so, there are studies that reported complete resolution of all features of PCOS, even hirsutism, hyperandrogenism, anovulation, and menstrual irregularity.
Part of the book: Debatable Topics in PCOS Patients