My Favorite Drugs
With PCOS being a stubborn diagnosis, many healthcare professionals have turned to oral contraceptives to help their clients cope with some of their symptoms. An individual's dependence on drugs depends on their circumstances and preferences. To alleviate the symptoms associated with PCOS, I advise people to follow an effective nutrition plan, supplementation, lifestyle modification, and exercise and sleeping practices. There are times when nutrition and lifestyle are not sufficient and other factors must be added to the equation. Everything has its purpose in life, but at the appropriate dosage and for a specific duration. The effects of drugs are hella powerful. Caution should be taken when using them and working with a healthcare professional is essential. The goal is to emphasize behavioral changes to things we do on a daily basis such as eating, sleeping, exercising, and managing stress. It's hoped that improvements come from the changes, but if not, pharmaceutical drugs should be the last resort. The majority of treatment protocols today include drugs and nutritional therapy together. With that said, let's list some common drugs prescribed to manage PCOS and their negative consequences.
Doctors usually opt for a combined oral contraceptive approach. There is a greater emphasis on the predominant symptoms than on the more complex ones, such as irregular menstruation, which can be triggered by a number of factors. For example, Yasmin® and other chemicals that have the ability to display anti-androgenic effects would be incorporated into treatment if androgen production is reckless. Therefore, hirsutism and acne complications are minimized. Metformin which belongs to the biguanides class, decreases liver glucose production, intestinal absorption, and increases insulin sensitivity. Though it is prescribed to reignite the ovulation cycle in PCOS individuals, it also provides an anti-hyperandrogenic effect for a short period of time. So far, everything about these medications sounds poppin', but the negative consequences of using them long-term or even in short bouts can really mess with some people.
Medications that belong to the estrogen and progestin group include Leveonogestrel/Ethinyl estradiol, Marvelon®, Mircette®, Diana 35®, Yasmin®, and Natazia®. In terms of pharmacology, the therapeutic purpose is to address menstrual cycles, hirsutism, and acne. It works by blocking ovulation through a negative feedback system within the hypothalamus, which alters the regular pattern of gonadotropin production from the anterior pituitary. A negative effect of such therapy is nausea, vomiting, headaches, depression, diarrhea, breast pain, etc.
Anti-androgens such as spironolactone (Aldactone®) and finasteride (Propecia®) are prescribed to treat hirsutism and acne. Competitive antagonistic activity against aldosterone receptors causes potassium retention, sodium excretion, and water retention. Furthermore, it inhibits Type II 5-alpha-reductase, an enzyme that turns testosterone into DHT. Side effects that are associated with these drugs are lowered libido, erectile problems, and ejaculation troubles.
Clomiphene citrate (Clomid®) is an anti-estrogen that stimulates the ovulatory process. According to scientific research, long-lasting estrogen receptor blockers inhibit estrogen negative feedback, which increases pulsatile GnRH secretion from the hypothalamus and pituitary gonadotropins. Consequences associated with ovarian enlargement are bloating, discomfort, headache, and abnormal uterine bleeding.
Letrozole (Femara®) is considered an aromatase inhibitor, which helps with ovulation. Chemically, this drug is a nonsteroidal competitive inhibitor of the aromatase enzyme that helps turn androgens into estrogens. The symptoms that come along with this drug are hot flashes, edema, headache, dizziness, and bone pain.
It depends on a person's situation whether or not medication is a suitable option for PCOS. To ensure the health of the client, the dosage and duration of treatment need to be considered. In a dire situation, drugs have their place, but nutrition and lifestyle changes need to be part of the first line of defense when it comes to PCOS. We eat, sleep, move our bodies and deal with stress EVERYDAY! Making changes to the way a person lives has the potential to have an impactful influence. Your general practitioner is the most appropriate person to help you. Adding a nutritionist into the mix to polish the nutrition aspect may tame the beast in PCOS. Let's take a pause here and pick up in the next script. As always, Stay Strong & Stay Vivid!
Reference
Sadeghi, G.M. et al. (2022). Polycystic Ovary Syndrome: A Comprehensive Review of Pathogenesis, Management, and Drug Repurposing. International Journal of Molecular Sciences. http://doi.org/10.3390/ijms23020583.
Rashid, R. et al. (2021). Polycystic ovarian síndrome-current pharmacotherapy and clinical implications. Taiwanese Journal of Obsterics and Gynecology. http://doi.org/10.1016/j.tjog.2021.11.009.
