Implications of Non-compliance in the Management of Chronic Polycystic Ovarian Syndrome

Polycystic ovarian syndrome (PCOS) is a reproductive endocrine disorder characterized by an imbalanced luteinizing hormone (LH) to follicle-stimulating hormone (FSH) ratio, which can lead to a range of complications, including infertility, metabolic disturbances, and cardiovascular disease. Diagnosis is based on the Rotterdam criteria, which require the presence of at least two of three features: oligo- or anovulation, clinical and/or biochemical hyperandrogenism, and polycystic ovaries. This case study follows a patient, from ages 28 to 34, who presents with complications while managing her PCOS. Diagnostic tests first confirmed excess androgen production and oligo-amenorrhea, leading to the initiation of metformin hydrochloride (HCl) and Lo Loestrin Fe, a low-estrogen oral contraceptive. However, the patient failed to comply with her medication regimen. Four years later, the patient returned with ongoing irregular bleeding episodes and severe hirsutism. This case addresses the importance of understanding medication non-compliance in the management of chronic conditions such as PCOS, where factors such as financial hardship and lack of understanding about the condition can hinder treatment adherence. Improved patient education, proactive management of medication side effects, and assistance with healthcare costs are essential to improving adherence and long-term health outcomes.