Women with PCOS and insulin resistance are at increased risk for impaired glucose tolerance or diabetes. Hypoglycemic agents can reduce circulating androgen levels, increase sex hormone binding globulin, facilitate weight loss, and induce ovulation.
Take steps to enhance or induce ovulation. Even women who do not desire fertility stand to gain, because chronic anovulation increases the risk of endometrial cancer.
Address hirsutism and other hyperandrogenic effects. Treatment of hirsutism is best approached with a combination of medical and mechanical means. Counsel patients that response is likely to be slow and subtle.