Management of polycystic ovary syndrome

Polycystic ovary syndrome (PCOS), also known as Stein-Leventhal Syndrome, is a condition that afflicts many women during their childbearing years. It is one of the leading causes of female infertility. Symptoms of PCOS are related to androgen excess and are not associated with estrogen deficiency. Classic symptoms include amenorrhea, hirsutism, acne, and obesity. Management of PCOS is directed by the client's concerns regarding symptoms, desire for pregnancy, and degree of morbidity related to androgen excess. First-line management of PCOS includes diet modification, weight loss, and stress management. First-line treatment for androgen excess is estrogen therapy, the combination of estrogen and progesterone being the drugs of choice. Uncomplicated amenorrhea in PCOS is managed with monthly or bimonthly administration of medroxyprogesterone. The antiestrogen clomiphene citrate has been the drug of choice for inducing ovulation. The success of any treatment plan will depend largely on the client's ability to reduce body weight.