PCOS: Treatment and support

Although PCOS is a long-term condition with no permanent cure, there are still plenty of ways to manage it. Treatments for PCOS range from medication to lifestyle changes, such as weight control, eating a healthy, minimally processed diet, and exercising regularly.
 
PCOS is always a unique experience; there’s no one-size-fits-all way of approaching treatment. Ultimately, you need to find what works for you. Fortunately, there are many helpful tools to draw on.  

 

What is PCOS?

PCOS is a complex – often challenging – endocrine disorder that affects 1 in 10 women in the UK (1). The exact cause of PCOS remains unknown, but insulin resistance, genetics, and higher-than-normal androgens – sometimes referred to as ‘male’ hormones – are thought to play a role.
 
PCOS can cause a range of troubling symptoms that generally appear during a woman’s late teens and early twenties, including acne, weight gain, and irregular periods. For some women, these changes can result in poorer mental health outcomes and low self-esteem.
 
While there’s no cure for PCOS, many dietary, lifestyle, and medical interventions are known to improve symptoms.
 

Irregular periods

 
Women with PCOS often experience irregular or absent menstrual cycles due to hormone imbalances, which affect ovulation. In some cases, this can lead to challenges with conception and family planning.
 

PCOS treatments for irregular periods

 
Making simple changes to your lifestyle can improve your overall hormonal health and support menstrual irregularities with PCOS.
 

Maintain a healthy weight

 
Being overweight can impact menstrual regularity because of the effect fat cells can have on hormones and insulin (2). Although PCOS can make weight loss harder, losing even a small amount can support menstrual health.
 
You can learn more about supporting PCOS weight loss here.
 

Move more

 
Together with a balanced diet, regular exercise can support weight loss and weight maintenance, which, in turn, may help regulate your menstrual cycle. Moving little and often is one of the best ways to increase your overall activity.
 

Reduce stress

 
High levels of stress can adversely affect the menstrual cycle. Stress releases cortisol and adrenaline, hormones that make it harder for insulin to work properly, which may worsen menstrual irregularity.
 
Yoga, meditation, journaling, and quality sleep are widely used to buffer against stress, but you have to find what works for you.
 

Add specific supplements

 
Experts often recommend myo-inositol, vitamin D3, magnesium, and a B vitamin complex to support menstrual health, so you may wish to incorporate them into your daily routine.
 

Try the oral contraceptive

 
The contraceptive pill isn’t an antidote for irregular periods, but health professionals often prescribe it to women with PCOS to restore some balance to the menstrual cycle.  
 
While birth control triggers an ‘artificial’ period, this bleed keeps many other important physiological functions working, such as bone health.
 
You can read more about supporting menstrual health with PCOS here.
 

Changes in hair growth

 
PCOS is driven by excessive levels of androgens, ‘male’ hormones, which can lead to changes in hair growth. It can cause both unwanted hair growth (hirsutism) and hair thinning (female pattern hair loss or androgenic alopecia), especially near the front of the scalp.
 

PCOS treatments for hair symptoms

 
Unusual hair growth and hair loss can be some of the most challenging aspects of PCOS. Such visible symptoms can negatively affect body image, mental health, and self-esteem.
 
Of course, it’s worth mentioning that you always have the final say on how your body looks. There’s nothing wrong with less or more facial and body hair. If, however, it bothers you, there are many things you can do.
 

Treatments for PCOS hair growth  

 

Hair removal

 
Getting rid of excess hair from PCOS is similar to traditional ways of removing unwanted hair. You can shave it, pluck it, wax it and even laser it.
 

Eat low-GI foods

 
High insulin levels increase androgen levels in your body: more insulin means more androgens and more androgens means more unwanted hair. So, you have to control your insulin levels to manage excessive hair growth.
 
Eating foods with a low glycaemic index (GI) – the rate at which a carbohydrate affects your blood sugar – can help manage insulin levels. Whole-grain bread, brown rice, quinoa, oats and legumes are great examples of low-GI foods that will help balance blood sugar levels. 
 

Try myo-inositol

 
Besides supporting menstrual regularity and ovulation, weight management, and acne, myo-inositol may also play a role in reducing excess hair growth (3).
 

Get enough emotional support

 
For some women, unwanted hair growth can lead to anxiety, depression, and insecurity. Joining a local PCOS group or chatting with a trained therapist are valid and important options if you need support.
 

Medical treatments for PCOS hair growth

 

Oral contraceptives

 
Oral contraceptives can prevent your ovaries from producing excessive amounts of testosterone, which may reduce unwanted hair growth (hirsutism).  
 
 

Co-cyprindiol

 
Co-cyprindiol is often recommended to manage facial and body hair growth.
 

Eflornithine cream

 
Eflornithine cream can be used to slow down the growth of unwanted facial hair.
 
Take a look at our guide on excessive hair growth (hirsutism) here.
 

Treatments for PCOS hair loss

 

Try to lose some weight

 
Research suggests weight loss can lower androgen levels, which may be helpful for PCOS hair loss (4). You can read more about sustainable PCOS weight loss here.
 

Optimise your nutrition

 
Vitamin C, vitamin D3, and biotin, a water-soluble B vitamin, have been associated with healthy hair growth, so you may wish to increase your intake of these nutrients.
 

Join a support group

 
PCOS is often linked to poorer mental health outcomes, particularly when it leads to such physical changes. Connecting with individuals who share similar experiences can be a valuable source of comfort.
 

Practice acceptance

 
Practising acceptance isn’t always easy when you’re dealing with hair loss. But it can be an empowering way to manage it. Though this mental shift may take time, try to remind yourself that your identity is more than your appearance.
 

Change your hairstyle

 
Sometimes, all you need is a different hairstyle to make you feel more confident. You can find plenty of inspiration online.
 
You can learn more about PCOS hair loss and thinning here.
 

Skin and acne

 
Higher-than-normal androgen levels, specifically testosterone, can also lead to skin changes in women with PCOS. These hormonal imbalances stimulate the sebaceous gland to produce more oil than necessary, which can block pores and create the perfect storm for acne (5).
 
Besides breakouts, PCOS may increase skin tags in the neck and armpit area, as well as dark patches of skin on the thighs, arms, neck, or breasts.
 

Treatments for PCOS skin changes

 
Skin changes can be some of the most challenging PCOS symptoms. But simple tweaks to your diet and lifestyle can help.
 

Avoid dairy

 
Though more research is needed, some studies suggest dairy consumption may aggravate acne (6). It might be worth experimenting with cutting it out to see if it helps.
 

Follow a low-GI diet

 
As with many areas of PCOS, following a low-GI diet is one of the best ways to support skin health. High-GI foods spike your blood sugar almost immediately, contributing to insulin resistance, increased androgen production, and inflammation, all of which can lead to acne breakouts.
 
Try to add more low-GI foods to your diet – quinoa, chickpeas, lentils, brown rice, rolled oats and sprouted grain bread – and eat fewer high-GI foods, such as white bread, pastries, and biscuits.
 

Feed your gut

 
Evidence suggests a leaky gut could be behind breakouts, with data highlighting increased gut permeability in people with acne (7).
 
Eating 30 different plant foods (fruit, vegetables, legumes, beans, whole grains, nuts, seeds, and herbs) weekly, increasing fermented foods, like kimchi and sauerkraut, and consuming food within a 12-14 window may support gut health.
 

Prioritise sleep

 
Getting enough sleep every night is essential for good skin health. Sleep deprivation compromises immune health, increases inflammation, and elevates stress in the body, making the skin more susceptible to breakouts (8).
 

Try tea tree oil

 
Known for its antimicrobial and anti-inflammatory properties, research routinely positions tea tree oil as a helpful tool to manage acne naturally (9).
 

Add specific supplements

 
High-strength fish oil – or vegan equivalent – zinc, selenium, vitamin E, vitamin C, and vitamin D3 have shown great promise at supporting skin health, so you may wish to add these supplements to your diet.
 

Consider prescription medication

 
In some cases, your GP might prescribe topical retinoids, topical antibiotics, antibiotic tablets, or the combined contraceptive pill to manage acne and support skin health.
 
Read more about navigating PCOS and skin changes here.
 

Fertility

 
The hormonal imbalances that earmark PCOS often result in menstrual irregularities, which can impact ovulation. And if you aren’t ovulating regularly, you may struggle to conceive.
 
Excessive levels of androgens and insulin – both of which characterise PCOS – can also disrupt ovulation and make it harder to fall pregnant.
 

PCOS treatments for fertility

 
Although PCOS can make family planning a little more challenging, it doesn’t mean it’s impossible. Many women with PCOS use a combination of lifestyle and medical interventions to support their fertility journey.
 

Maintain a healthy weight

 
If you’re overweight, losing even a small amount can help balance hormones, restore monthly ovulation, and increase the likelihood of a healthy pregnancy (10). Though weight loss can be tricker with PCOS, it’s still well within your reach.
 
You can read our tips to support healthy, sustainable weight loss here.
 

Balance your diet

 
Eating a minimally processed, whole-food diet – with plenty of fibre-rich, plant foods, including fruit, vegetables, beans, legumes, whole grains, nuts, and seeds – will support weight management and reduce insulin resistance, both of which can interfere with ovulation.
 
Equally, try to reduce your intake of simple carbohydrates – ‘beige’ foods, like white pasta, bread, and rice – refined sugar, as they can trigger an almost immediate spike in blood sugar levels.
 
Take a look at the best dietary changes to support conception with PCOS here.
 

  Add specific supplements

 
Besides eating a healthy, balanced, and diverse diet, nutritionists often recommend fish oil – or a vegan alternative – B complex, and myo-inositol to support female fertility, so you may wish to add these supplements to your daily routine.
 

Try acupuncture

 
The traditional Chinese practice of acupuncture may support hormone regulation, promote ovulation, and reduce insulin resistance, potentially making it a useful tool for women with PCOS looking to improve their fertility (11).
 

Reduce stress

 
Evidence suggests chronic stress may contribute to insulin resistance, which is known to drive symptoms, like menstrual irregularities and fertility issues (12). 
 
Trying for a family is already emotionally exhausting, so diarising daily downtime – be it regular exercise, gardening, or yin yoga – is especially important as you navigate the reproductive journey with PCOS.   
 

Medical PCOS treatments for fertility issues

 

Clomifene 

 
Often the first treatment recommended to women with PCOS trying for a baby, clomifene encourages the monthly release of an egg from the ovaries.
 

Metformin 

 
If clomifene hasn’t helped, you may be advised to take metformin, which can support regular menstruation, stimulate ovulation, and lower the risk of miscarriage.
 

Letrozole

 
In some cases, letrozole is offered to stimulate ovulation instead of clomifene.
 

Gonadotrophins

 
If you struggle to fall pregnant despite taking oral medicines, your GP may recommend a different type of medicine called gonadotrophins, which is administered by injection.
 

IVF

 
If fertility medications haven’t helped, you may be encouraged to have in vitro fertilisation (IVF) treatment. IVF collects the eggs from the ovaries and fertilises them outside the womb. Once fertilised, the egg or eggs are placed back into the womb.
 

Surgery

 
Those who don't respond to medication may be offered a minor surgery called laparoscopic ovarian drilling. This procedure involves making several small holes in each ovary with a laser to correct hormone imbalance and restore the function of the ovaries.
 
You can read more about PCOS, pregnancy, and fertility here.
 

Weight

 
Weight gain and PCOS often go hand in hand. Generally speaking, this is down to insulin resistance, though poor emotional health can play a role, too.
 
Insulin helps transfer glucose from the bloodstream into the cells for energy. When the body is insulin resistant, it can produce insulin but can’t use it properly. As such, the pancreas releases more insulin to compensate, leading to a build-up of blood sugar, which can cause weight gain.
 
Excess weight can also exacerbate many aspects of PCOS, as it can make the body produce even more insulin.
 
 

PCOS treatments for weight loss

 
For women with PCOS, losing weight can improve many of the troublesome symptoms, like acne, excess facial hair, and irregular periods. Although insulin resistance can make weight loss harder, it’s still very possible. Losing even a small amount of weight can help, too.
 

Choose complex carbohydrates

 
You don’t need to cut carbs entirely to support PCOS weight loss. Simply adding more complex carbohydrates, like quinoa, buckwheat, whole-wheat pasta, sweet potatoes, and brown rice, and eating fewer simple carbohydrates, such as white pasta, breakfast cereals, and sweets, can help.
 

Support gut health

 
Research now suggesting a healthy, diverse gut may play a role in weight maintenance (13). To support gut health, try eating 30 different plant foods (fruit, vegetables, nuts, seeds, whole grains, legumes, and beans) weekly and include more fermented foods, like kimchi.
 

Increase protein

 
Protein is essential for metabolic function and satiety, making it one of the best tools for weight loss. Try to include a protein source – animal (meat, fish, and eggs) or plant-based (quinoa, pulses, beans, tofu, tempeh, nuts, and seeds) – at every meal to keep you full and satisfied.
 

Practice self-compassion

 
Speaking to yourself with kindness and compassion will help you feel worthy of lifestyle change. And if you indulge one day, don't beat yourself up. You’re only human.
 

 Get enough sleep

 
One night of poor sleep can disrupt the hormones responsible for hunger and fullness, which may contribute to weight gain. Try to get at least 7-9 hours of sleep every night.
 

Try orlistat

 
Designed to complement a balanced diet and regular exercise, orlistat is a medication that supports weight loss by decreasing fat absorption from the intestine lumen. Some studies suggest it may be useful for women with PCOS who find weight loss particularly difficult (14).
 
However, it’s worth mentioning that orlistat is associated with a number of side effects, including gastrointestinal issues, back pain, stomach pain, and headaches. Always have a thorough discussion with your GP before taking it.
 
You can find out more about healthy PCOS weight loss here.
 

Mental health

 
PCOS extends far beyond the physical. It can affect mental health, too, leading to an increased risk of anxiety, depression, and low self-esteem.
 
Several factors could be behind poorer psychological outcomes, including hormonal imbalances and the challenging nature of symptoms, such as excess facial and body hair and fertility issues.
 

PCOS treatments for mental health issues

 
Treatment for PCOS requires a 360-degree approach. And looking after your mental health remains a top priority.   
 

Focus on gut health

 
The gut and the brain have a bidirectional relationship through the gut-brain axis: the gut signals to the brain; and the brain signals to the gut. Therefore, looking after your gut means looking after your brain.
 
As mentioned, you can improve your gut health by eating more fibre-rich plants (fruit, vegetables, beans, legumes, whole grains, nuts, and seeds) and fermented foods, like kombucha and sauerkraut.
 

Balance blood sugar levels

 
Poor blood sugar management closely mirrors mental health symptoms, like anxiety and irritability, so restoring some balance to your blood sugar levels will lend itself to better emotional regulation.
 
Reducing refined sugar, increasing complex carbohydrates, like quinoa, buckwheat, and whole-wheat pasta, and taking a short walk after eating can help smooth any glucose curves.  
 

Take care with caffeine and alcohol

 
Both caffeine and alcohol can be triggers for people with anxiety and depression, so it might be an idea to reduce your intake.
 

Seek supplemental support

 
Magnesium, 5-HTP, ashwagandha, St John’s Wort, omega-3, and vitamin D3 are often recommended to support emotional and psychological health.
 

Try mind-body exercises

 
Many people turn to mind-body exercises, like yoga, diaphragmatic breathwork, and meditation, to manage their emotional wellbeing.
 
You can find out more about supporting your mental health with PCOS here.
 

PCOS supplementation

 
Besides dietary, lifestyle, and medical interventions, you may wish to incorporate the following supplements into your routine to support your health and happiness with PCOS.
 

Myo-inositol

 
Myo-inositol has shown great promise at supporting many aspects of PCOS, including restoring ovulatory activity, decreasing insulin resistance – which drives many symptoms – and supporting mood (15).
 
The recommended dose of myo-inositol for women with PCOS is 2 grams in the morning and 2 grams in the evening. For convenience, choose powdered myo-inositol and mix it with water or juice.
 

Vitamin D3

 
Evidence suggests low vitamin D3 may contribute to insulin resistance, hirsutism, weight gain, ovulatory and menstrual irregularities, and difficulties falling pregnant (16).
 
Taking a high-strength vitamin D3 supplement can help support your daily intake.
 

Gut-friendly supplements

 
As established, supporting your gut can positively impact many PCOS symptoms, including skin changes, weight gain, and mental health challenges.  
 
In addition to eating more plants and fermented foods, you may also wish to add high-strength live cultures and a natural soluble fibre called Fructo-Oligosaccharides (FOS) to your diet to support gut health.
 

Other noteworthy supplements

 
A high-strength fish oil – or vegan alternative – magnesium, zinc, vitamin B6, and N-acetyl-cysteine (NAC) may also support women with PCOS.
 
Read our guide on the best supplements for PCOS here.
 

Find out more

 
Although you can't permanently cure PCOS, treatment in the way of dietary, lifestyle, and medical interventions can help you manage it.
 
If you found this overview of PCOS treatments useful, you can find similar guidance on our dedicated health hub. Alternatively, please get in touch with our team of expert Nutrition Advisors, who are on hand to provide free, confidential advice.

 

References:

1. Verity PCOS UK (2023) Verity. Available at: http://www.verity-pcos.org.uk/

2. Itriyeva K. (2022) The effects of obesity on the menstrual cycle. Curr Probl Pediatr Adolesc Health Care. 52(8):101241.

3. Vyas L, Raiturker AP, Sud S, et al. (2022) Management of polycystic ovary syndrome among Indian women using myo-inositol and D-chiro-inositol. Bioinformation. 18(2):103-110.

4. Moran L. (2011) Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database Of Systematic Reviews.

5. Cutler DA, Pride SM, Cheung AP. (2019) Low intakes of dietary fiber and magnesium are associated with insulin resistance and hyperandrogenism in polycystic ovary syndrome: A cohort study. Food Science & Nutrition. 7(4):1426–1437.

6. Elsaie, M.L. (2016). Hormonal treatment of acne vulgaris: an update. Clinical, Cosmetic and Investigational Dermatology. 9, 241–248.

7. Juhl CR, Bergholdt HKM, Miller IM, Jemec GBE, Kanters JK, Ellervik C. (2018) Dairy Intake and Acne Vulgaris: A Systematic Review and Meta-Analysis of 78,529 Children, Adolescents, and Young Adults. Nutrients. 10(8):1049.

8. Lee YB, Byun EJ, Kim HS. (2019) Potential Role of the Microbiome in Acne: A Comprehensive Review. J Clin Med. 8(7):987.

9. Albuquerque RGR, et al. (2014). Could adult female acne be associated with modern life? Archives of Dermatological Research. 306 (8): 683–688.

10. Malhi HK, Tu J, Riley TV, Kumarasinghe SP, Hammer KA. (2017) Tea tree oil gel for mild to moderate acne; a 12-week uncontrolled, open-label phase II pilot study. Australas J Dermatol. 58 (3): 205-210.

11. Norman RJ, Noakes M, Wu R, Davies MJ, Moran L, Wang JX. (2004) Improving reproductive performance in overweight/obese women with effective weight management. Hum Reprod Update. 10: 267-280.

12. Ye Y, Zhou CC, Hu HQ, Fukuzawa I, Zhang HL. (2022) Underlying mechanisms of acupuncture therapy on polycystic ovary syndrome: Evidences from animal and clinical studies. Front Endocrinol (Lausanne). 13:1035929.

13. Yan YX, Xiao HB, Wang SS, Zhao J, He Y, Wang W, Dong J. (2016) Investigation of the Relationship Between Chronic Stress and Insulin Resistance in a Chinese Population. J Epidemiol. 26(7): 355-360.

14. Insenser M, Murri M, Del Campo R, Martínez-García MÁ, Fernández-Durán E, Escobar-Morreale HF. (2018) Gut Microbiota and the Polycystic Ovary Syndrome: Influence of Sex, Sex Hormones, and Obesity. J Clin Endocrinol Metab. 103(7): 2552-2562.

15. Ghandi S, Aflatoonian A, Tabibnejad N, Moghaddam MH. (2011) The effects of metformin or orlistat on obese women with polycystic ovary syndrome: a prospective randomized open-label study. J Assist Reprod Genet. 28(7): 591-596.

16. Inositol (2023) Miscarriage Research. Available at: https://sites.google.com/site/miscarriageresearch/supplements-and-miscarriage/d-chiro-inositol

17. Thomson R, et al. (2012) Vitamin D in the aetiology and management of polycystic ovary syndrome. Clinical Endocrinology. 77(3), 343-350.

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Disclaimer: The information presented by Nature's Best is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications.

 

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