What is the best treatment method for women with PCOS in Singapore?

Doctor's Answers (1)

I probably wouldn’t call it “best treatment”. The term “most suitable treatment” would probably be a better term to use. The treatment plan would be tailored to what your priorities are. For example, if you’re having difficulty conceiving, Clomiphene is a medication used to help induce ovulation, so you can predict when you’re ovulating and time intercourse accordingly.

If you’re overweight, weight loss (either by lifestyle modification or with medical therapy) is an important aspect of treatment. I find Metformin useful in this aspect, and it also helps to improve regularity of the menstrual periods and is generally very well tolerated.

If you’re suffering from symptoms or signs of excess male hormones (acne/facial hair), spironolactone (a medication that blocks the male hormones) +/- the oral contraceptive pill can be used. In severe cases, I find that both of these, taken together with Metformin, to be effective. The oral contraceptive pill should be used cautiously in obese women, as the risk of having thrombosis (clot formation) is higher.

In women who have very irregular periods, progesterone tablets taken every 2 months can help induce a period and shed the lining of the womb. This ensures womb health and reduces the risk of womb cancer. Metformin can help regulate the periods, and whilst on metformin and waiting for periods to become more regular, a 1-week course of progesterone can be taken if you haven’t had a period for 2 months.

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