What is the management for a PCOS patient showing early visible changes of hirsutism who requires menstrual cycle control?

The management of a patient with polycystic ovary syndrome (PCOS) who is experiencing early visible changes of hirsutism along with a need for menstrual cycle control can effectively be addressed with the use of combined estrogen and cyproterone acetate. This approach is particularly beneficial because cyproterone acetate is an anti-androgen medication that can help mitigate hirsutism by blocking the effects of androgens that may contribute to excessive hair growth.

In addition, the inclusion of estrogen helps in regulating menstrual cycles and can also promote regular ovulatory function, thereby addressing both the menstrual irregularities and hirsutism simultaneously. This combination therapy is often effective in managing the symptoms of PCOS while providing cycle control.

Other options may not provide the comprehensive management that combined therapy offers. For instance, progesterone-only therapy does not directly address hirsutism and may not effectively regulate the menstrual cycle in the same way as the combined approach. Metformin is primarily used to manage insulin resistance and may assist with menstrual control over time but is less effective in treating hirsutism directly. Clomiphene citrate is utilized mainly for ovulation induction and does not address the menstrual cycle control in the context of hirsutism