The primary treatment for PCOS is weight loss through diet and exercise. Modest weight loss can lower androgen levels, improve hirsutism, normalize menses, and decrease insulin resistance. It may take months to see these results, however. 21 Use of oral contraceptive pills or cyclic progestational agents can help maintain a normal endometrium. The optimal cyclic progestin regimen to prevent endometrial cancer is unknown, but a monthly 10- to 14-day regimen is recommended. 21 Insulin sensitizing agents such as metformin (Glucophage) can reduce insulin resistance and improve ovulatory function. 21 , 25 , 26
According to The Mayo Clinic , male hypogonadism can begin during fetal development, before puberty, or even during adulthood. In the case of adult hypogonadism, the condition can cause erectile dysfunction, infertility, decrease in beard and body hair growth, decrease in muscle mass, development of breast tissue, and loss of bone mass. The condition can also cause mental and emotional changes similar to those women may experience during menopause. These may include fatigue, decreased sex drive, difficulty concentrating, and hot flashes, The Mayo Clinic reported.
Levels of prostate-specific antigen (PSA) should be checked at 3, 6, and 12 months. If the patient is truly hypogonadal to begin with, expect a significant rise at the 3-month assessment. Thereafter, the usual criteria apply regarding the possible presence of an underlying malignancy (>4 ng/mL, or rate of increase > ng/mL/2 yr or >2 ng/mL overall). These criteria continue to be revised by our urology colleagues, tending to become more stringent with time. For example, a PSA rise of more than 1 ng/mL/year has been suggested as an early warning guide, and closer surveillance has been recommended, even at rates of to ng/mL/year. 2 A digital rectal examination should be performed at 3 to 6 months and at 1 year after therapy is initiated. A urologic consultation should be obtained if indicated.