In the hands of a skilled and experienced technical, ultrasound imaging of the uterus can be highly useful in helping to detect early precancerous endometrial changes. Agents such as Glucotrol should only be used when insulin sensitizing conditions have failed to be effective. Nonetheless, it does work for some patients, particularly in combination with other therapies, and can sometimes be used as a treatment of last resort, particularly for patients who are already undergoing a laparoscopy for other reasons. One of the difficulties of ovarian drilling is that more aggressive ovarian drilling is associated with better outcomes, but can also also be associated with higher risk of adhesion formation. Interestingly, ovarian drilling is generally ineffective in smokers.
Oral contraceptives suppress the pituitary-produced hormones that stimulate the ovaries.
Therefore, in cases where elevated androgens are ovarian in origin, oral contraceptives will be associated with decreased androgen levels.