Polycystic ovarian syndrome
Treatment of oligomenorrhoea
Combined oral contraceptive (see Contraception section).
Medroxyprogesterone
Medroxyprogesterone 10mg tablets
10mg twice daily for 7 days every 3-4 months.
Prescribing Notes:
- Recommendations for combined oral contraceptives can be found in the Contraception section of the formulary.
- Polycystic ovarian syndrome consists of a collection of symptoms some or all of which may not require drug treatment; weight reduction is first essential line of management for obese patients.
- Treatment with combined oral contraceptive or medroxyprogesterone require prior assessment of endometrial thickness.
- Recommendations for Acne are detailed in the Skin chapter of the formulary.
- If there are concerns regarding infertility, both the male and female partners should be referred to a clinic. Ovulation induction with anti-oestrogens may be required and should only be prescribed with appropriate monitoring.
- There is some evidence that metformin may increase frequency of ovulation, but the appropriate dose is unclear.
History Notes
18/05/2022
East Region Formulary content agreed.
Treatment of hirsutism
Ethinylestradiol + Desogestrel
Cimizt 30microgram/150microgram tablets
1 tablet daily for 21 days, to be started on day 1 of menstrual cycle; subsequent courses repeated after a 7-day interval (during which withdrawal bleeding occurs).
Co-cyprindiol
Co-cyprindiol 2000microgram/35microgram tablets
1 tablet daily for 21 days, to be started on day 1 of menstrual cycle; subsequent courses repeated after a 7-day interval (during which withdrawal bleeding occurs), time to symptom remission, at least 3 months; review need for treatment regularly.
Prescribing Notes:
- Polycystic ovarian syndrome consists of a collection of symptoms some or all of which may not require drug treatment; weight reduction is first essential line of management for obese patients.
- Recommendations for Acne are detailed in the Skin chapter of the formulary.
- Millinette (ethinylestradiol/gestodene) 30/75 contains a less androgenic progestogen and may be used instead of Cimzt 30/150 in women with hirsutism or acne.
- Anti-androgens, spironolactone and cyproterone acetate, may be used for hirsutism when the use of oestrogen containing products are not desirable.
History Notes
18/05/2022
East Region Formulary content agreed.