In normal weight individuals with PCOS insulin levels are generally not elevated and response to Glucophage is poor. In these cases ovulation inducing agents are preferable. Although Glucophage is a class B drug, we recommend discontinuation of use when pregnancy is diagnosed. Since there is not one medication that completely reverses the abnormalities of polycystic ovarian disease, we generally focus on the goals of the patient. Our goals of management are to reduce long term sequelae.
Treatment of obesity is always clinically challenging.
The main approach has been one of diet and exercise. However, many patients will respond to Glucophage in addition to diet and exercise. We have seen patients in the practice that have lost 30-80 lbs. Before initiating a management scheme for hirsutism it is important to assess the degree of hirsutism. Take into consideration in addition to the patient s physical appearance, any ancillary cosmetic measures that she is utilizing including electrolysis and use of facial creams or shaving.