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It is most common in women under 30 years old and many ovarian cysts disappear without treatment. They also produce the female hormones estrogen and progesterone. Often in PCOS patients, periods start at the usual age of 12-13, while some start menstruating earlier. The severity of PCOS symptoms can vary widely from woman to woman. Treatment modalities for hirsutism include ovarian and adrenal suppression, anti-androgen therapy and local hair removal measures. Oral contraceptives are simple and relatively safe method of ovarian suppression, in addition the estrogen component increases the sex hormone binding globulin (SHBG) with a resultant decrease in free testosterone. It competitively inhibits intracellular dihydrotestosterone receptors within the hair follicles.
Both cimetidine and cyproheptadine (a serotonin and histamine antagonist) have weak anti-androgenic effects.
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