How Does Letrozole Work for PCOS?

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Polycystic ovary syndrome (PCOS) is a hormonal disorder that affects the reproductive and metabolic health of people assigned female at birth. It is characterized by elevated levels of male hormones and multiple cysts on the ovaries. If you have PCOS, you may be interested in participating in a clinical trial to access the latest treatments that are not yet widely available. By joining a clinical trial, you can also contribute to finding a cure for this condition.

Understanding Polycystic Ovary Syndrome (PCOS)

Polycystic ovary syndrome is a condition in which the levels of male hormones are higher than normal in people assigned female at birth. This hormonal imbalance can prevent the ovaries from releasing fully developed eggs, leading to the formation of multiple small cysts on the ovaries. This can significantly reduce fertility and cause symptoms such as hirsutism, male pattern baldness, acne, and weight gain. While birth control pills are a standard treatment for PCOS, people who are trying to conceive may require different treatments.

What is Letrozole (Femara) and How Does it Help with PCOS?

Letrozole is an aromatase inhibitor that reduces estrogen production and is used to treat infertility in people with PCOS. Although it is not specifically approved to treat PCOS-related infertility, studies have shown that it is comparable to the older first-line treatment, clomiphene. Letrozole works by temporarily blocking the production of estrogen, which induces ovulation. It is often prescribed alongside clomiphene or metformin.

The Benefits of Letrozole for PCOS Patients

Letrozole is prescribed solely to improve fertility and does not help with the general symptoms of PCOS. However, taking letrozole significantly increases the chances of pregnancy and birth as long as it is used correctly and intercourse is timed afterward. It also has a lower risk of multiple births compared to clomiphene.

Who Should Avoid Taking Letrozole?

If you are pregnant or breastfeeding, you should avoid taking letrozole. Letrozole can potentially harm the fetus, and exposure to lactating rats was associated with impaired fertility in male offspring. You should also avoid letrozole if you are taking ethinylestradiol, tamoxifen, or any other medication that impacts estrogen levels.

Letrozole Dosage for PCOS Treatment

Letrozole comes in 2.5-milligram oral tablets. For fertility treatment, you will be told to take 2.5 to 7.5mg daily (one to three tablets) starting between the third and seventh day of your menstrual cycle. You will take it for five days, and intercourse should be timed afterward. The dosage is lower if you have a kidney or liver condition. If you do not become pregnant, you may repeat the treatment or try something else.

Side Effects of Letrozole for PCOS

Letrozole can have several side effects, including joint pain, hot flashes, headaches, and nausea. However, because letrozole is taken for a short period of time, significant weight gain is less likely.

Alternatives to Letrozole

If letrozole does not work for you or is contraindicated, there are other alternatives you can use, such as clomiphene, metformin, or gonadotropins. People with PCOS are also recommended to pursue lifestyle changes such as quitting smoking, reducing alcohol intake, eating a healthy diet, and exercising to improve their fertility.

The Lowdown

Letrozole has become a first-line treatment for people with PCOS who wish to become pregnant. It is generally more successful than clomiphene and carries less risk of conceiving twins. However, it is not recommended for all patients, does not work for everyone, and should be avoided if breastfeeding. There are other treatments for PCOS-related infertility that may or may not work better for you. With treatment, most people with PCOS can successfully conceive and give birth to a healthy baby, and letrozole is one of the tools that can allow them to do so.