Treatment Options for PCOD (Polycystic Ovarian Disease)

The exact cause of PCOD is not fully understood, but several factors are thought to contribute:

• Hormonal Imbalance: High levels of androgens (male hormones) and insulin resistance contribute to the symptoms of PCOD.

• Genetics: A family history of PCOD can increase the risk.

• Insulin Resistance: Many women with PCOD have insulin resistance, which means their body does not use insulin effectively, leading to higher insulin levels and further hormonal imbalance.

1. Lifestyle Changes

• Healthy Diet: A balanced, low-glycemic index diet rich in fiber can help manage insulin levels and support weight management.

• Exercise: Regular physical activity helps reduce weight, improve insulin sensitivity, and regulate hormonal levels.

• Weight Management: Losing even a small percentage of body weight (5-10%) can improve symptoms like irregular periods and ovulation.

2. Medications

• Oral Contraceptives: Birth control pills regulate menstrual cycles, reduce androgen levels, and alleviate symptoms like acne and excess hair growth.

• Anti-Androgens: Medications like spironolactone block the effects of androgens, helping reduce symptoms like unwanted facial and body hair.

• Metformin: This medication is used for women with insulin resistance, as it helps regulate insulin levels and can improve ovulation.

• Clomiphene Citrate or Letrozole: These medications are used to stimulate ovulation in women trying to conceive.

3. Fertility Treatments

• Intrauterine Insemination (IUI): Used in combination with ovulation induction medications for women who have difficulty conceiving.

• In Vitro Fertilization (IVF): In cases where IUI is not successful, IVF may be recommended as a fertility treatment.

4. Surgical Treatment

• Laparoscopic Ovarian Drilling (LOD): A surgical procedure that reduces androgen production in the ovaries and may help restore normal ovulation.

5. Managing Symptoms of Excess Hair and Acne

• Laser Hair Removal or Electrolysis: These procedures can help reduce unwanted hair.

• Topical Treatments and Medications: Acne may be managed with topical retinoids or antibiotics, and other hair removal methods may also be considered.

PCOD is a manageable condition, and treatment can significantly improve symptoms and help women with PCOD achieve their reproductive goals. A combination of lifestyle changes, medications, and possibly fertility treatments can help manage the condition and improve overall quality of life. Consulting a healthcare provider is important to create a personalized treatment plan based on individual symptoms and goals.

PCOD (Polycystic Ovarian Disease), also known as PCOS (Polycystic Ovary Syndrome), cannot be completely cured, as it is a chronic condition. However, its symptoms can be effectively managed with the right treatment and lifestyle changes.

PCOD is a hormonal disorder that results from a combination of genetic and environmental factors. The imbalance of hormones, such as high levels of androgens (male hormones), and insulin resistance, is often a lifelong issue that cannot be entirely reversed. Additionally, women with PCOD may experience symptoms intermittently, and they may vary in severity.

While PCOD may not have a cure, there are several ways to manage the condition and reduce its impact:

1. Lifestyle Changes: Maintaining a healthy diet, regular exercise, and weight management can significantly improve symptoms, regulate periods, and improve fertility.

2. Medications: Hormonal birth control, anti-androgens, and insulin-sensitizing drugs like metformin help manage the symptoms effectively.

3. Fertility Treatments: For women struggling with fertility, treatments like ovulation induction medications or assisted reproductive technologies (e.g., IUI or IVF) can help achieve pregnancy.

4. Symptom Management: Acne, excess hair growth, and other cosmetic issues can be treated with medications, laser hair removal, or other therapies.

With proper treatment, most women with PCOD can lead a normal, healthy life. Managing the condition effectively can help alleviate symptoms, improve fertility, and reduce the risk of long-term complications like diabetes or heart disease. Regular check-ups with healthcare providers are essential for ongoing management.

Although PCOD cannot be "cured" completely, it is manageable. Early diagnosis, lifestyle modifications, and medical interventions can help control the symptoms and improve quality of life.

Managing PCOD (Polycystic Ovarian Disease) through lifestyle changes is an essential part of controlling symptoms, improving overall health, and reducing the risk of long-term complications like insulin resistance and infertility. Here are some key lifestyle changes that can help manage PCOD effectively:

1. Healthy Diet

• Balanced Diet: Focus on a nutritious, well-balanced diet rich in whole foods, vegetables, fruits, lean proteins, and healthy fats.

• Low Glycemic Index (GI) Foods: Foods with a low glycemic index help stabilize blood sugar levels, improve insulin sensitivity, and reduce the risk of developing type 2 diabetes. Examples include whole grains, legumes, leafy greens, and non-starchy vegetables.

• High-Fiber Foods: A high-fiber diet can help regulate insulin levels and support hormonal balance. Fiber-rich foods include oats, legumes, and vegetables like broccoli, spinach, and beans.

• Avoid Processed Foods: Reduce the intake of processed foods, sugary snacks, and refined carbohydrates, as they can worsen insulin resistance and contribute to weight gain.

2. Regular Physical Activity

• Exercise Regularly: Physical activity helps improve insulin sensitivity, manage weight, and regulate hormone levels. Aim for at least 30 minutes of moderate-intensity exercise, such as walking, cycling, or swimming, most days of the week.

• Strength Training: Incorporating strength training exercises, like weightlifting or resistance band exercises, can help build muscle, boost metabolism, and improve insulin sensitivity.

• Yoga and Mindfulness: Yoga, along with mindfulness practices like meditation, can help reduce stress and improve mental well-being, which can, in turn, benefit hormone regulation.

3. Weight Management

• Weight Loss: Losing even a small percentage (5-10%) of body weight can help regulate menstrual cycles, improve ovulation, reduce androgen levels, and improve insulin sensitivity.

• Consistent Monitoring: Tracking your weight and body measurements can help you stay motivated and focused on your health goals.

• Avoid Crash Dieting: Opt for a gradual, sustainable weight loss plan instead of extreme diets that may negatively impact your hormones and overall health.

4. Stress Management

• Reduce Stress: Chronic stress can disrupt hormonal balance, leading to worsened symptoms of PCOD. Stress management techniques such as deep breathing exercises, meditation, and mindfulness can help regulate stress hormones like cortisol.

• Sleep Well: Adequate sleep is crucial for hormone regulation. Aim for 7-8 hours of quality sleep each night to support overall health.

5. Hydration

• Drink Plenty of Water: Staying hydrated helps your body function optimally, supports digestion, and aids in managing weight. Drinking enough water can also improve skin health, which is important for managing acne associated with PCOD.

6. Avoiding Smoking and Excessive Alcohol Consumption

• Quit Smoking: Smoking can worsen insulin resistance, increase androgen levels, and negatively impact fertility in women with PCOD.

• Limit Alcohol: Excessive alcohol intake can contribute to weight gain, hormonal imbalance, and liver stress, making it more difficult to manage PCOD symptoms.

7. Regular Monitoring and Medical Guidance

• Regular Checkups: Regular visits to a healthcare provider, including an endocrinologist or gynecologist, can help monitor symptoms, track progress, and adjust treatment plans as needed.

• Manage Underlying Conditions: Women with PCOD should monitor and manage other health conditions like insulin resistance, thyroid disorders, or high blood pressure, which can exacerbate PCOD symptoms.

Adopting a healthy lifestyle with a focus on balanced nutrition, regular exercise, stress management, and weight control plays a significant role in managing PCOD. These lifestyle changes not only help in controlling symptoms like irregular periods, weight gain, and acne but also improve overall health and reduce the risk of long-term complications. Always consult with a healthcare provider to create a personalized plan that works best for you.

Several medications are commonly prescribed to manage PCOD (Polycystic Ovarian Disease) symptoms. The type of medication prescribed will depend on the specific symptoms, whether the individual is trying to conceive, and any underlying health conditions such as insulin resistance. Below are the most common medications used for PCOD:

1. Oral Contraceptives (Birth Control Pills)

• Purpose: Regulate menstrual cycles, reduce excess androgens (male hormones), and manage symptoms such as acne, hirsutism (excess hair growth), and scalp thinning.

• How it works: Oral contraceptives combine estrogen and progestin to regulate the hormonal imbalance associated with PCOD. These hormones prevent ovulation and help restore normal menstrual cycles.

2. Anti-Androgens

• Spironolactone:

  • Purpose: Reduce symptoms like excessive hair growth (hirsutism) and acne caused by high androgen levels.

  • How it works: Spironolactone blocks the effects of male hormones (androgens) on the body, which helps improve skin and hair symptoms.

  • Note: Spironolactone should not be used during pregnancy as it can affect fetal development.

• Flutamide:

  • Purpose: Also used to treat hirsutism and acne.

  • How it works: Blocks the action of androgens on hair follicles and sebaceous glands.

3. Insulin-Sensitizing Medications

• Metformin:

  • Purpose: Used for women with insulin resistance or who are overweight to improve insulin sensitivity and regulate blood sugar levels.

  • How it works: Metformin helps lower insulin levels and improve ovulation, making it particularly helpful for women with PCOD who are struggling with fertility.

• Other Insulin Sensitizers: In some cases, other medications like glibenclamide or rosiglitazone may be prescribed to help with insulin resistance.

4. Ovulation-Inducing Medications

• Clomiphene Citrate (Clomid):

  • Purpose: To stimulate ovulation in women with PCOD who are struggling with infertility.

  • How it works: Clomiphene works by blocking estrogen receptors, prompting the body to produce more follicle-stimulating hormone (FSH), which helps trigger ovulation.

• Letrozole (Femara):

  • Purpose: Another medication used to induce ovulation in women with PCOD.

  • How it works: Letrozole works by inhibiting the production of estrogen, which stimulates the ovaries to produce eggs and induces ovulation. It is often considered more effective than Clomid in women with PCOD.

• Gonadotropins (Injectable hormone therapies):

  • Purpose: For women who do not respond to oral medications, gonadotropins like FSH (follicle-stimulating hormone) or hCG (human chorionic gonadotropin) may be used to stimulate the ovaries directly.

  • How it works: These injections stimulate the ovaries to produce mature eggs and increase the chances of pregnancy.

5. Progestins

• Purpose: Used to regulate menstrual cycles, especially in women who have irregular periods and are not using birth control pills.

• How it works: Progestins are synthetic forms of progesterone. They help regulate the lining of the uterus, promote regular bleeding, and reduce the risk of endometrial cancer due to prolonged absence of menstruation.

6. Fertility Treatments (IVF)

• In Vitro Fertilization (IVF):

  • Purpose: IVF is a more advanced fertility treatment used when other options fail. It involves stimulating ovulation, retrieving eggs from the ovaries, fertilizing them in a laboratory, and then implanting the fertilized embryos in the uterus.

  • How it works: IVF bypasses many of the issues associated with ovulation and helps women with PCOD who have difficulty conceiving naturally.

7. Topical Treatments for Skin Issues

• Topical Retinoids (e.g., tretinoin):

  • Purpose: Used to treat acne, which is a common symptom of PCOD.

  • How it works: These topical medications promote skin cell turnover and help reduce acne breakouts.

• Benzoyl Peroxide or Salicylic Acid:

  • Purpose: Over-the-counter treatments for acne that can complement prescription medications in managing PCOD-related skin issues.

8. Laser Hair Removal or Electrolysis

• While not a medication, laser hair removal and electrolysis are often used in conjunction with anti-androgen medications to help permanently reduce unwanted hair growth caused by PCOD.

The treatment plan for PCOD typically involves a combination of medications, lifestyle changes, and sometimes fertility treatments, depending on the symptoms and individual goals (such as managing symptoms or improving fertility). It is essential to work with a healthcare provider to develop a personalized approach to treatment.

Weight loss can significantly improve the symptoms of PCOD (Polycystic Ovarian Disease) by addressing several underlying factors such as insulin resistance, hormonal imbalance, and irregular ovulation. Even a modest weight loss (around 5-10% of body weight) can have a profound effect on managing the condition. Here's how weight loss helps improve PCOD symptoms:

1. Improves Insulin Sensitivity

• Insulin Resistance is a common issue in women with PCOD. The body’s inability to use insulin effectively leads to higher levels of insulin in the bloodstream, which can worsen hormonal imbalances and contribute to symptoms like weight gain, irregular periods, and infertility.

• Weight loss improves insulin sensitivity, meaning the body can process insulin more effectively, leading to lower insulin levels and better control over blood sugar. This helps regulate hormones and may improve ovulation.

2. Regulates Hormone Levels

• Excess weight—particularly abdominal fat—can increase the production of androgens (male hormones like testosterone) in women with PCOD. High androgen levels are responsible for symptoms such as excess facial or body hair (hirsutism), acne, and scalp hair thinning.

• Losing weight helps reduce fat cells, which in turn reduces the production of androgens. This can lead to a decrease in unwanted hair growth and skin issues like acne.

3. Restores Regular Menstrual Cycles

• Women with PCOD often experience irregular or absent periods due to hormonal imbalances. The presence of excess fat can exacerbate this issue.

• Weight loss can help restore a more regular menstrual cycle by improving hormonal regulation, especially estrogen and progesterone levels. This may make ovulation more regular and improve fertility.

4. Improves Fertility

• One of the main concerns for women with PCOD is infertility due to irregular ovulation. Losing weight can help normalize ovulation, increasing the chances of conception.

• With reduced insulin levels and better hormonal balance, women may experience more regular ovulation cycles, making it easier to get pregnant naturally or with the help of fertility treatments.

5. Reduces the Risk of Long-Term Health Complications

• Women with PCOD are at higher risk for developing conditions like type 2 diabetes, heart disease, and high blood pressure due to insulin resistance and obesity.

• Weight loss helps lower the risk of these health conditions by improving insulin function, reducing cholesterol levels, and supporting heart health.

6. Enhances Mood and Reduces Stress

• Stress and mood disorders, such as anxiety and depression, are common in women with PCOD, and excess weight can contribute to a negative body image and emotional distress.

• Weight loss, combined with physical activity, can improve mental well-being by boosting serotonin levels, which helps reduce stress and improve mood. This, in turn, can positively impact the hormonal regulation of the body.

7. Reduces Inflammation

• Obesity can lead to chronic low-grade inflammation in the body, which may worsen PCOD symptoms.

• Losing weight reduces inflammation, helping to alleviate symptoms such as ovarian cysts, irregular cycles, and hormonal imbalances.

Conclusion

While weight loss alone may not cure PCOD, it is one of the most effective ways to manage symptoms and improve overall health. By improving insulin sensitivity, balancing hormone levels, regulating menstrual cycles, and increasing fertility, weight loss plays a vital role in managing PCOD. A healthy, balanced diet combined with regular physical activity is the most effective approach for sustainable weight loss and symptom management. Always consult with a healthcare provider before starting a weight loss plan to ensure it's safe and tailored to individual needs.

Is surgery an option for PCOD treatment?

Yes, surgery can be an option for PCOD (Polycystic Ovarian Disease) treatment, but it is generally considered only after other non-surgical methods, such as lifestyle changes and medications, have been tried and proven ineffective. Surgery is typically considered when fertility is a concern or when there are severe, persistent symptoms. The most common surgical procedure for PCOD is ovarian drilling, but there are other options depending on the individual's specific situation.

1. Ovarian Drilling (Laparoscopic Ovarian Surgery)

• What it is: This is a minimally invasive surgery in which small punctures are made in the ovaries using a laser or an electric needle. The goal is to destroy some of the ovarian tissue, which can reduce the levels of androgens (male hormones) and help restore ovulation.

• Why it’s done: Ovarian drilling is primarily used for women with PCOD-related infertility who have not responded to fertility medications like Clomid or Metformin. It can help improve ovulation and restore normal menstrual cycles.

• Effectiveness: Ovarian drilling can be very effective in promoting ovulation, and many women conceive naturally after the procedure. However, its effectiveness may decrease over time.

• Risks: Risks include infection, bleeding, and scarring of the ovaries, which could potentially affect future fertility.

2. Laparoscopic Ovarian Cyst Removal

• What it is: If a woman with PCOD has large, painful ovarian cysts that are not responsive to medication, a doctor may suggest laparoscopic cyst removal.

• Why it’s done: This procedure is performed when cysts cause significant pain or other complications like rupture.

• Effectiveness: Removing the cysts can help relieve pain and prevent further complications, and it may also improve ovarian function.

• Risks: As with any surgery, there are risks, such as infection, bleeding, and potential damage to surrounding tissues.

3. Hysterectomy (Rarely Used)

• What it is: A hysterectomy is the surgical removal of the uterus, and in extreme cases, the ovaries may also be removed.

• Why it’s done: This procedure is usually reserved for women with severe, chronic symptoms who have not found relief with other treatments, and in cases where there are serious concerns like endometrial cancer or severe bleeding. It is often considered in women who have completed their family-building.

• Effectiveness: A hysterectomy is a permanent solution for eliminating PCOD symptoms, but it comes with the significant drawback of permanently ending fertility.

• Risks: Major surgery risks include infection, blood loss, and hormonal imbalances after the removal of ovaries (if performed).

4. Bariatric Surgery (Weight Loss Surgery)

• What it is: Bariatric surgery like gastric bypass or sleeve gastrectomy may be considered for women with PCOD who are severely overweight and have not been able to lose weight through diet and exercise.

• Why it’s done: Weight loss surgery can significantly improve insulin sensitivity, reduce androgen levels, and help regulate menstrual cycles, which may improve fertility in women with PCOD.

• Effectiveness: Studies show that bariatric surgery can help women with PCOD reduce symptoms such as irregular periods and hirsutism (excess hair growth). Weight loss can also improve fertility in some cases.

• Risks: As with any major surgery, bariatric surgery carries risks of complications, including infection, malnutrition, and long-term digestive issues.

When Is Surgery Considered?

Surgery is generally considered in the following cases:

• When medications and lifestyle changes (like diet and exercise) have not been effective in managing symptoms.

• When fertility is a primary concern, other treatments (like ovulation-inducing drugs) have failed.

• When large ovarian cysts cause persistent pain or other complications.

• When there are chronic, severe symptoms (like abnormal bleeding or pain) that affect quality of life and have not been resolved through non-surgical treatments.

Surgery for PCOD is generally reserved for women who have not responded to other treatments, particularly when infertility or severe symptoms are present. The most common surgical options are ovarian drilling and cyst removal, both of which are minimally invasive procedures. Hysterectomy and bariatric surgery are considered more drastic and are used in specific cases. Before considering surgery, it’s important to explore all non-surgical treatment options with a healthcare provider to determine the most appropriate approach for managing PCOD.

Yes, women with PCOD (Polycystic Ovarian Disease) can conceive naturally, but it may be more challenging compared to women without the condition. PCOD can affect fertility due to irregular or absent ovulation (the release of eggs from the ovaries), hormonal imbalances, and insulin resistance, but many women with PCOD can still get pregnant naturally, especially with the right treatment and lifestyle adjustments.

Here are a few key points to consider regarding natural conception for women with PCOD:

1. Ovulation Problems

• One of the main challenges with PCOD is that many women experience irregular ovulation or don't ovulate at all. This makes it more difficult to predict fertile days and increases the chances of infertility.

• However, many women with PCOD do ovulate occasionally, and with the right timing, conception can occur. Tracking ovulation through basal body temperature (BBT), ovulation predictor kits, or ultrasound monitoring can help pinpoint the most fertile days.

2. Hormonal Imbalance

• Women with PCOD often have higher levels of androgens (male hormones) like testosterone, which can interfere with ovulation and cause symptoms like excess facial or body hair and acne.

• Balancing hormones can be achieved through lifestyle changes or medications (e.g., Metformin to improve insulin sensitivity or Clomid to induce ovulation). These treatments can significantly increase the chances of conceiving naturally.

3. Insulin Resistance

• Insulin resistance is common in women with PCOD, which can lead to higher levels of insulin in the bloodstream. This can worsen hormonal imbalances and affect ovulation.

• Weight loss and a healthy diet, along with medications like Metformin, can help manage insulin resistance and improve the chances of conception.

4. Managing PCOD Symptoms

• For many women, managing PCOD-related symptoms like excess weight and hirsutism can help restore hormonal balance and improve fertility. Regular exercise, a balanced diet, and maintaining a healthy weight can help regulate menstrual cycles and support ovulation.

• Addressing stress through relaxation techniques like yoga or meditation may also improve overall health and fertility.

5. Fertility Medications

• If natural conception is not successful, fertility medications such as Clomid (which stimulates ovulation) or Letrozole can be used to help women with PCOD ovulate and increase the chances of pregnancy. These medications are commonly used for women with PCOD who have trouble ovulating on their own.

6. Success Rates

• Many women with PCOD can conceive naturally, especially if they are able to regulate their menstrual cycles and ovulation through lifestyle changes, medications, or other treatments.

• However, the success rate can vary depending on the severity of PCOD, age, overall health, and other individual factors. Women who are under 35 with mild PCOD may have a higher chance of conceiving naturally compared to older women or those with more severe symptoms.

When to Seek Help

If a woman with PCOD is trying to conceive for 6 to 12 months without success, it may be time to consult a fertility specialist. A healthcare provider can assess fertility potential and discuss options, including medications or assisted reproductive technologies (ART) like in vitro fertilization (IVF) if necessary.

While PCOD can make conception more challenging due to irregular ovulation and hormonal imbalances, many women with the condition can still conceive naturally. With lifestyle changes, managing insulin resistance, and using fertility medications if needed, the chances of natural conception are significantly improved. If natural conception proves difficult, there are several treatment options available, including medications and assisted reproductive techniques, to help women with PCOD achieve pregnancy.

The time it takes to see improvement in PCOD (Polycystic Ovarian Disease) symptoms with treatment can vary significantly from woman to woman. Several factors influence how quickly symptoms improve, including the severity of the condition, the type of treatment used, individual health, and adherence to lifestyle changes. Here’s a breakdown of what to expect for different treatment options:

1. Lifestyle Changes (Diet and Exercise)

• Time to Improvement: You may start to see some improvement in insulin sensitivity, weight, and menstrual cycles within 3 to 6 months of adopting healthy lifestyle changes. These include a balanced diet, regular physical activity, and stress management.

• How it works: For women with insulin resistance or excess weight, lifestyle changes can have a significant impact on hormone regulation, menstrual regularity, and overall fertility. However, the process can take time, as the body gradually adapts to the changes.

• Symptom Improvement: Symptoms like irregular periods, weight gain, and acne may begin to improve as insulin levels stabilize and hormone balance is restored. Regular exercise can also help reduce abdominal fat and regulate ovulation.

2. Medications (Metformin, Birth Control Pills, Clomid)

• Metformin (for insulin resistance):

  • Time to Improvement: 2 to 6 months. Metformin helps improve insulin sensitivity, which can regulate menstrual cycles, lower testosterone levels, and improve ovulation. Some women notice improvement in symptoms such as acne and excessive hair growth after a few months.

• Birth Control Pills (to regulate hormones and periods):

  • Time to Improvement: 1 to 3 months. Birth control pills are commonly prescribed to manage irregular periods and reduce symptoms like excessive hair growth, acne, and hirsutism. Most women see improvement in period regularity and skin health within a couple of months.

  • Symptom Improvement: After starting the pill, you may notice more regular periods and reduced facial hair or acne within 2 to 3 months.

• Clomid (to induce ovulation):

  • Time to Improvement: If you're using Clomid for infertility, it may take 1 to 3 cycles (each cycle lasting about a month) to see improvement and to achieve ovulation. If Clomid is effective, ovulation may occur within the first few cycles, leading to pregnancy in some cases.

  • Symptom Improvement: Women using Clomid may experience more regular ovulation, which can lead to conception.

3. Ovulation Induction (Letrozole)

• Time to Improvement: Like Clomid, Letrozole (another ovulation-inducing medication) can show effects within 1 to 3 cycles. Some studies suggest that Letrozole might be more effective than Clomid for women with PCOD, particularly for those who have not responded well to Clomid.

• Symptom Improvement: As ovulation improves, menstrual cycles become more regular, and the chances of conception increase.

4. Ovarian Drilling (Surgery)

• Time to Improvement: After ovarian drilling, many women notice improvements in ovulation within 1 to 3 months. Ovulation may occur more regularly, leading to more predictable menstrual cycles and improved fertility.

• Symptom Improvement: The procedure can also lead to reduced testosterone levels, improving symptoms like excessive hair growth and acne.

5. Bariatric Surgery (Weight Loss Surgery)

• Time to Improvement: Significant changes in PCOD symptoms such as regular periods, improved insulin sensitivity, and weight loss can be seen within 6 to 12 months after surgery. However, it depends on the individual’s weight loss progress and how well they maintain healthy habits post-surgery.

• Symptom Improvement: Improvement in ovulation, hormonal balance, and insulin resistance can be seen after significant weight loss, leading to a reduction in PCOD symptoms.

6. Other Considerations

• Stress Management: Improvements in stress-related symptoms (such as acne, irregular periods, and weight gain) can be noticed within a few weeks to a few months after adopting relaxation techniques like meditation, yoga, or deep breathing exercises.

• Hair Growth: For symptoms like hirsutism (excessive hair growth), visible improvement may take several months of treatment with hormonal therapies or medications like spironolactone, or after ovarian drilling.