12th April 2024

Management

General weight reduction should be advised to all if appropriate. The management options depend on whether the patient is considering pregnancy. 

Selective oestrogen receptor modulators such as clomifene or aromatase inhibitors such as letrozole are highly effective in inducing ovulation. Clomifene has an increased risk of inducing ectopic and multiple pregnancies. The overall effectiveness of metformin concerning fertility is still contested. It may be useful in select patients with weight loss requirements and glycaemic control.

Those not considering pregnancy can take the combined oral contraceptive pill (COCP), which promotes regulation of the menstrual cycle. It has also been shown to treat hirsutism and other hyperandrogenic symptoms. Eflornithine cream can be prescribed for facial hirsutism but is only effective in a minority of cases.