What is Drug Treatment of PCO:?? Ans:- AS no cause is known for PCO in a given case with certainty so Tr is directed to symptom with which an adolescent PCO presents to family physician /Gynaecologist/Endocrinologist . Admittedly there is no single drug or specific agent have been discovered till date for management of PCO and as mentioned it is symptom oriented,.
•Therefore be it adolescent or adult PCO the drugs prescribed are as per symptoms with which she presents .
For instance for A) Obesity : diet control and Exercise, : B) For oligomenorrhoea -> cyclical Medroxyprogesterone 10 mg OD for 12 days per month or COC with high oestrogen to increase SHBG and C) for abnormal hair growth cyproterone containg OCP and or antiandrogens( are usually prescribed. Metformin or myoinositol ,Vit D, antioxidants , Statins are added at the discretion of physician Cosmesis (laser therapy )/ Laser epilation/ different chemical depilators are used. has a great immediate role enabling her to attend college, social meets.thereby avoiding embarrassment Of all the known antiandrogens Spironolactone (Brand Aldactone ) 100 mg OD at morning for 6 months will be very effective(competes with DHT at skin receptors and safe also) but Na K estimation 3 monthly is warranted. The next choice drug for Hirsutism is Cyporoterone acetate in high doses like 50/100 mg(Brand name Androcur-Schering), the third and fourth antiandrogens are FLUTAMIDE 250 mg TDS and Finasteride 5 mg OD(brand name is Finast ) .The last one is inhibitor of 5 alpha reductase which converts testosterone (T4 -->DHT) at hair follicles, .These are not so popular,
OCP however may be combined with all tese four antiandrogens .While OCP will curtail androgens centrally but antiandrogens will counteract with Dihydro testosterone at hair follicles the active hormone for stimulating the hair follicles, To conclude though Aldactone is safe and popular the side effects should be communicated earlier like a) menst irregularities 2) mastodynia 3) weakness due to K loss 4) Loss of scalp hairs and rarely urticaria,
Those seeking fertility restoration : may opt for Ovulation induction preceded by achieving optimum BMI but a threat of miscarriage in PCO women will remain so also PIH . Metformin therapy will reduce miscarriage rate in PCO and Ut artery Doppler at N T Scan will pick up PCO cases who are candidates for 150 mg aspirin.
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