# Implications of Non-compliance in the Management of Chronic Polycystic Ovarian Syndrome

**Authors:** Avarie Willette, Taylor Nicely, Elliot Cazes

PMC · DOI: 10.7759/cureus.79501 · 2025-02-23

## TL;DR

This case study highlights how non-compliance with medication can worsen PCOS symptoms and emphasizes the need for better patient education and support.

## Contribution

The study provides insights into the impact of medication non-compliance on PCOS management and suggests strategies to improve treatment adherence.

## Key findings

- The patient's non-compliance with PCOS medication led to ongoing complications like irregular bleeding and severe hirsutism.
- Factors like financial hardship and lack of understanding hinder treatment adherence in chronic conditions like PCOS.
- Improved patient education and healthcare cost assistance are essential for better PCOS management.

## Abstract

Polycystic ovarian syndrome (PCOS) is a reproductive endocrine disorder characterized by an imbalanced luteinizing hormone (LH) to follicle-stimulating hormone (FSH) ratio, which can lead to a range of complications, including infertility, metabolic disturbances, and cardiovascular disease. Diagnosis is based on the Rotterdam criteria, which require the presence of at least two of three features: oligo- or anovulation, clinical and/or biochemical hyperandrogenism, and polycystic ovaries. This case study follows a patient, from ages 28 to 34, who presents with complications while managing her PCOS. Diagnostic tests first confirmed excess androgen production and oligo-amenorrhea, leading to the initiation of metformin hydrochloride (HCl) and Lo Loestrin Fe, a low-estrogen oral contraceptive. However, the patient failed to comply with her medication regimen. Four years later, the patient returned with ongoing irregular bleeding episodes and severe hirsutism. This case addresses the importance of understanding medication non-compliance in the management of chronic conditions such as PCOS, where factors such as financial hardship and lack of understanding about the condition can hinder treatment adherence. Improved patient education, proactive management of medication side effects, and assistance with healthcare costs are essential to improving adherence and long-term health outcomes.

## Linked entities

- **Chemicals:** metformin hydrochloride (PubChem CID 14219), Lo Loestrin Fe (PubChem CID 63020)
- **Diseases:** cardiovascular disease (MONDO:0004995)

## Full-text entities

- **Diseases:** hyperandrogenism (MESH:D017588), infertility (MESH:D007246), oligo-amenorrhea (MESH:D000568), metabolic disturbances (MESH:D024821), reproductive endocrine disorder (MESH:D004700), oligo- or anovulation (MESH:D000858), bleeding (MESH:D006470), PCOS (MESH:D011085), hirsutism (MESH:D006628), cardiovascular disease (MESH:D002318)
- **Chemicals:** metformin hydrochloride (MESH:D008687)
- **Species:** Homo sapiens (human, species) [taxon 9606]

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Source: https://tomesphere.com/paper/PMC11935641