Reducing Meds in PCOS

[Ange]

Greetings
I have a 26 yr old client diagnosed with PCOS in her early teens with symptoms of acne and hirsuitism. At 16 years she was put on Ginette and Spironolactone. She also had and still has fatigue and was diagnosed with Hashimoto's also. Its a fairly complex case.

My question to practitioners is, as I support my client to reduce and then eliminate these two meds, which is our intention, should I address the Ginette and Spironolactone concurrently or do one before the other. Thanks for any insights.

Ange Palmer - Medical Herbalist

[Ange]

Further to my question, my strategy would likely be to get her off the OCP, restabilise her hormones and liver cleanse with herbs and then reduce the Spironolactone slowly over ?6 months. Your thoughts appreciated...

[Lara]

Hi Ange,

The goal is to try to re-establish ovulation as quickly as possible, to obtain the anti-androgen benefits of estradiol and progesterone. Towards that end, I might approach this case by suggesting first coming off Ginet OCP but stay on a low dose (eg. 50 mg) of spironolactone at least for the first few months to shelter from the rebound androgens and acne from coming off Ginet. Unfortunately, spironolactone can also suppress ovulation but usually only at higher doses. Eventually, with the goal to taper down spiro.

And (even with spiro) be prepared for serious post-pill acne, which would typically hit about 3 months off Ginet. She'll likely need dairy-free, zinc, all the skin treatments.