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Polycystic ovarian syndrome (PCOS) is among the most common yet misunderstood female hormonal disorders worldwide. Leaving it unaddressed and mismanaged could lead to other, more severe health problems. The key to better health is how endocrinologists treat PCOS by taking a holistic approach to their care. Here is an explanation of an endocrinologist and what they can do for women with PCOS.
Women with PCOS don’t always know that endocrinologists are the most essential doctors they should see for their condition. Endocrinologists specialize in hormonal imbalances and related conditions, such as the following:
These endocrine specialists work to create hormonal regulation to ensure your body’s systems correspond and communicate. Concerning PCOS, endocrinologists issue several blood tests to measure the imbalances and indicate androgen and testosterone levels. They guide patients on various lifestyle changes to improve function and prescribe medicine as needed.
Currently, there is no set treatment or cure for PCOS. Endocrinologists and related specialists are actively trying to understand the root cause, how it develops over time, and possible medications to help with symptoms and prevent risk factors.
Some of the queries doctors ask include whether women with PCOS have different ovaries than non-PCOS patients, how weight relates to PCOS and whether a fetus exposed to male hormones has a higher chance of developing the condition. Doctors also question whether to screen PCOS patients for endometrial cancer because of the heightened risk.
Managing PCOS and finding relief from symptoms is no easy feat — every patient is different and requires a unique approach. Endocrine specialists are equipped with extensive knowledge of hormonal imbalances and several treatments up their sleeves for individualized care. Here is how endocrinologists treat PCOS.
Lifestyle changes are the cornerstone of PCOS management and most endocrinologists’ first line of treatment. Healthy habits are essential to prevent the onset of other serious diseases.
For instance, over 50% of women with PCOS develop type 2 diabetes before turning 40. Other risks include cardiovascular disease, endometrial and ovarian cancer, sleep apnea and abnormal lipids.
An endocrinologist might suggest a low-calorie and low-sugar diet to control your blood sugar and weight better. Some studies also show that yoga and 120 minutes of high-intensity exercise benefit women with PCOS.
Although there is no cure for PCOS, many patients opt for birth control pills to balance their hormones. Of course, this is only a viable treatment for women who do not wish to get pregnant.
Endocrinologists prescribe combined hormonal birth control — comprising estrogen and progesterone — to patients with PCOS. Ultimately, the pills regulate menstruation, leading to fewer follicles on your ovaries. Some pills have helped patients manage hirsutism — unwanted hair growth on the chest, back, stomach or face — and acne.
Studies even indicate a 30%–40% reduction in endometrial cancer risk when taking oral contraceptives.
Because women with PCOS tend to produce more androgens — a male hormone — endocrinologists may prescribe anti-androgen medications like spironolactone or cyproterone. These medicines address several PCOS symptoms, including excess hair growth and acne.
Some women may prefer to try an androgen-blocking medicine instead of birth control. While there is not an FDA-approved treatment for PCOS, these medications work well for many people.
The way diabetes patients get treated for insulin sensitivity is how endocrinologists treat PCOS patients — with metformin. Metformin decreases how much glucose you absorb from the foods you eat and limits how much glucose your liver produces. This is highly beneficial to women with PCOS who have developed pre-diabetes or diabetes.
According to one study, long-term use of metformin helps women reduce their body mass index to a healthier weight, increase the number of menstrual cycles — improving the chances of women getting pregnant — and decreasing testosterone and androgens.
PCOS affects 8%–13% of women of reproductive age and is the leading cause of infertility. For one thing, PCOS may cause less ovulation, making it harder to conceive. Women also wait longer to start their families — for instance, to establish themselves in a career, buy a house or save money.
As such, endocrinologists can prescribe ovulation induction medicine like clomiphene citrate to kickstart menstruation and increase your chances of becoming pregnant. A reproductive endocrinologist — a specialist in obstetrics and gynecology with extensive experience in endocrine disorders — may be better suited for you to overcome infertility with PCOS.
Some women require laparoscopic ovarian drilling — a minimally-invasive surgery in which the doctor drills small holes into the ovaries to induce ovulation.
In women with PCOS, the outer layer of the ovaries tends to be thicker. By drilling through the surface, doctors can decrease testosterone levels so the ovaries can more easily release an egg during menstrual cycles. Nearly 50% of women get pregnant after drilling.
Unlike fertility treatments, ovarian drilling is a one-time surgical treatment. However, women hoping for twins or triplets have a better chance of conceiving them through more traditional in vitro fertilization.
Because of its reproductive nature, women often visit a gynecologist first for a PCOS diagnosis and management. Indeed, a gynecologist serves a purpose by providing pelvic exams, ultrasounds of the ovaries, birth control and monitoring for signs of endometrial, ovarian and cervical cancer. Obstetricians are also crucial for addressing infertility concerns.
However, a good gynecologist should encourage you to see an endocrine specialist if they suspect PCOS, as they are the best doctors to treat hormonal disorders.
If you have recently been diagnosed with PCOS, ask your gynecologist to refer you to an endocrinologist or look up a specialist in your insurance plan. Having a team of doctors for a more holistic approach to treatment and management is better than strictly seeing a gynecologist.
PCOS is multifaceted, with numerous symptoms and risk factors. Although an endocrinologist specializes in treating hormonal disorders, seeking care with a team of highly qualified doctors will ensure whole-body management of PCOS.
