PCOS: Hair Growth, Birth Control, and Ovulation Concerns

Polycystic Ovarian Syndrome (PCOS) Medication Consultation

Hello, I have previously asked about the issue of hirsutism related to polycystic ovary syndrome (PCOS).
I would like to clarify whether the oral contraceptives you mentioned can suppress the hair growth that has already occurred on the body or if they only affect future hair growth influenced by hormones.
For the hair that has already grown, would laser treatment be necessary?
Additionally, I would like to ask about the medication prescribed by my doctor, which seems to be ovulation-inducing drugs.
If I take these long-term, will my body still be unable to ovulate on its own? How can I determine if I am ovulating? Do I need to go to the hospital for testing? Furthermore, I experience bleeding close to my ovulation period every month; will taking these medications exacerbate this issue?

jen, 10~19 year old female. Ask Date: 2018/05/09

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the treatment for Polycystic Ovary Syndrome (PCOS) aimed at addressing issues such as hirsutism, acne, and other related symptoms can include the use of contraceptive pills or anti-androgen medications to increase sex hormone-binding globulin levels in the body, thereby alleviating symptoms caused by excess androgens.
However, it is important to note that symptoms like hirsutism, which are caused by elevated androgen levels, require blood tests for further evaluation to rule out other conditions before a diagnosis can be confirmed; treatment should not be based solely on the use of contraceptive pills.
Therefore, you should first consult a physician to check for any other underlying conditions that may be causing hirsutism before proceeding with treatment.
Ovulation medications should be prescribed based on a physician's assessment and indications, and generally do not have the side effects mentioned.
If bleeding persists or is excessive, it is advisable to consult the prescribing physician for evaluation.
Thank you! Wishing you peace and health, Dr.
Zhang.

Reply Date: 2018/05/09

More Info

Polycystic Ovary Syndrome (PCOS) is a complex hormonal disorder that affects many women of reproductive age. One of the common symptoms associated with PCOS is hirsutism, which is excessive hair growth in areas where men typically grow hair, such as the face, chest, and back. This condition is often linked to elevated levels of androgens, which are male hormones that can lead to hair loss on the scalp (androgenic alopecia) and increased body hair.

1. Oral Contraceptives and Hair Growth: Oral contraceptives (birth control pills) can indeed help manage the symptoms of PCOS, including hirsutism. They work by regulating hormone levels, which can reduce the production of androgens from the ovaries. This means that while they can help prevent new hair growth in areas where it is undesirable, they may not necessarily remove hair that has already developed. For existing hair, treatments such as laser hair removal or electrolysis may be more effective. These methods target the hair follicles directly and can lead to permanent hair reduction.

2. Ovulation and Fertility Medications: Regarding the medications prescribed to you, it sounds like you may have been given ovulation induction agents. These medications are designed to stimulate the ovaries to produce eggs and can be beneficial for women with PCOS who are trying to conceive. However, it is important to understand that these medications do not guarantee that your body will ovulate naturally without them. Regular monitoring through blood tests or ultrasounds is often necessary to determine if ovulation is occurring.
If you are experiencing breakthrough bleeding or irregular menstrual cycles while on these medications, it is crucial to discuss this with your healthcare provider. They can assess whether the current treatment plan is appropriate or if adjustments are needed.
3. Monitoring Ovulation: To determine if you are ovulating, healthcare providers typically recommend tracking your menstrual cycle, using ovulation predictor kits, or undergoing blood tests to measure hormone levels. Additionally, ultrasound examinations can help visualize the ovaries and assess follicular development.
4. Long-term Management of PCOS: Managing PCOS often requires a multifaceted approach, including lifestyle changes such as maintaining a healthy weight, regular exercise, and a balanced diet. These changes can help improve insulin sensitivity and may lead to a reduction in androgen levels, which can alleviate symptoms like hirsutism and hair loss.

5. Conclusion: In summary, while oral contraceptives can help manage new hair growth associated with PCOS, they may not eliminate existing hair. For that, laser treatments may be necessary. Monitoring ovulation and menstrual cycles is essential, especially when taking fertility medications. If you have concerns about your treatment plan or symptoms, it is always best to consult with your healthcare provider for personalized advice and adjustments to your treatment strategy.
PCOS is a chronic condition, but with the right management and support, many women can lead healthy lives and effectively manage their symptoms.

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