I want to preface this with I am not a doctor and I am not here to tell you what to do medically or judge you for any decision you make. I am here to help inform you and I want to share pros and cons so you can make an informed decision
1. Birth Control- probably the most common and least helpful (in my opinion) medical intervention for PCOS. What it does- gives you the illusion of regular periods with none of the benefits. Hormonal birth control suppresses your natural hormones and floods your body with synthetic hormones preventing ovulation. This does not help balance out any of the hormones that are often off due to PCOS. In face many women coming off of birth control experience what is sometimes referred to as post pill PCOS because the synthetic hormones create a feed back loop with our adrenals that then can cause your adrenals to become over active when you go off the pill.
2. Metformin- Metformin is a type 2 diabetes drug so it makes sense that it’s useful for those with PCOS as a high percentage of women with PCOS also have insulin resistance. Metformin may help you manage your PCOS and regain normal ovulation of insulin resistance is the root cause of your PCOS. The cons are it often times has nasty side effects akin to IBS and more recently has been investigated as a possible cause of cancer. In fact many women report that they don’t get the IBS side effects if they reduce their carb intake so it may make more sense to skip the drug and just change your diet. If you want to avoid these nasty side effects try starting a low carb/keto diet for a few months and then slowly add in some good slow processing carbs.
3. Clomid/Femara- both of these fertility drugs are often used with women with PCOS because they affect your estrogen levels with the hope of inducing earlier ovulation. This is can be a quick fix for those wanting to get pregnant now. The cons… lots of crazy side effects like mood swings, insomnia, headaches, and hot flashes. It also depletes your body of some necessary vitamins and minerals so your egg quality may go down. Finally, this is just a band aid fix for ovulation it actually throws your hormones even further out of whack instead of getting to the root cause and balancing your hormones.
4. Ovarian Drilling- ovarian drilling is a surgical procedure that is sometimes performed on women with PCOS where they also have chronically poly cystic ovaries. The thought is by going in and lasering some of the cysts on the ovaries hormonal balance can be restored due to less ovarian tissue putting out hormones. Unfortunately, this comes with some risks. One of those risks is developing so much scar tissue from the procedure that your ovaries no longer work.
5. Ovarian Wedge Resection- this surgical procedure was actually invented in the early 1900’s and was widely practiced for decades with good results. During this procedure the doctor goes in and takes a wedge out of your ovary and sews your ovary back together creating a smaller and more normal sized ovary. Similar to ovarian drilling this is believed to work because by removing the excess tissue you have less hormone secretion. This practice had been largely forgotten since the introduction of clomid due to concerns over scarring, however there are some doctors who have now been trained in a new way to complete this procedure that reduces scarring greater increasing positive outcomes.