Polycystic ovary syndrome: How best to manage

The symptoms of polycystic ovary syndrome (PCOS) can be managed with combination oral contraceptives (OCs), progestins, antiandrogens, insulin sensitizers, agents for ovulation induction, and weight reduction in overweight patients. Combination OCs are first-line therapy for acne and hirsatism; they are also a highly effective means of achieving menstrual cycle regularity. If possible, select an OC with a minimally androgenic progestin. All women with PCOS need to be screened with blood pressure measurement, a lipid panel, and both fasting glucose and 2-hour oral glucose tolerance tests. Maintain a high index of suspicion for endometrial hyperplasia and carcinoma in women with PCOS who have amenorrhea or abnormal bleeding in the third or fourth decade of life.