PCOS, Mental Health, and Treatment Challenges: A Support Inquiry

Question
Hi,
My sister was diagnosed with PCOS when she was 16. Due to quite a bit of laziness on her behalf, she only really started taking her treatment regimen seriously in the last two years (she is 23 now). She's taking metformin, Diane and cyproterone acetate. Her main problem is her hair loss and facial hair. She is also obese. It is really, really  depressing her as her medications are not working and she has tried to lose weight with little success.

I was wondering if there were any alternative, successful treatments? How much worse could her condition get? I am very worried about her mental health, as she spends hours arranging her hair so it will hide the thin patches at her crown, which she becomes extremely distressed and paranoid with. Is there anything I can do other than offer her support?

Thanks,
Sam.

Answer
PCOS is a multifactorial syndrome and I can't offer any suggestions for your sister without knowing the entire extent of her work up and symptoms. Has she had a recent sonogram? That may help in seeing if she, indeed, still has PCOS (as she did at age 16). Metformin has been shown to help9 tremendously, but she will have to work very hard in weight control. Has she consulted her gynecologist and endocrinologist lately?  I understand what you are saying as far as her self-image and body image, and if it is interfering in her daily life, she must seek professional care (therapist, psychologist, etc). It appears that she is doing the right thing now, but will need aggressive management by a professional. There are medications that can help her hirsuitixm and hair loss. Discuss it with her gynecologist. Good Luck.