Author(s): Vaijinath Biradar1 , Sangeeta Tengli2
Medical treatments for PCOS are usually aimed at improving the clinical, endocrine and metabolic effects of this disease. A combination of hormonal contraceptives, progestins, insulin sensitizing agents and statins is effective, and also has metabolic and endocrine benefits. However, their long-term effects in terms of preventing the complications of PCOS, such as cardiovascular disease and diabetes, are still unknown and their adverse effects limit long-term use. Additionally, their effects on ovulation rates and hirsutism varied in women with PCOS. Resistance to clomiphene citrate (CC) is quite common (15-20%) along with variable efficacy. Metformin, the commonly prescribed drug for insulin resistance poses the patient to risk of hypoglycemia and increase in serum homocysteine level. Thus, available treatment is not without dis advantages and their adverse effects can limit the success of the treatment. Therefore, new agents are needed which treats PCOS with minimal side effects. Myoinositol is an important constituent of follicular microenvironment, playing a determinant role in both nuclear and cytoplasmic oocyte development. It positively affects hyperinsulinemia and oocyte's quality. It improves ovarian function and pregnancy rate. NAC has got multiple mechanism of actions including antioxidant property, has anti-apoptotic effect, vaso dilating effect, anti-inflammatory effect etc. It not only improves insulin sensitivity in hyperinsulinemic patients with PCOS but also shows better improvement in acne, hirsutism and weight gain compared to metformin. It helps in restoring the menstrual regularity.