Hello XXXXXXX

Thanks for writing to us.

Can you please upload necessary investigations that you had done previously? Also please include last report one.

It will help me to guide you properly with suggestive measures. I am waiting for your response and reports also.

Regards,
Dr Soumen

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Hello XXXXXXX

Thanks for your response.

OK, it is fine. You can upload all necessary reports including recent one by tomorrow.

Regards,
Dr Soumen

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Hello XXXXXXX

Thanks for uploading all reports. I am trying to give answer as per your concern.

First of all, your all reports were within normal range while you were under medication.

Your condition is called oligomenorrhoea (irregular delayed period) in medical term along with presence of hirsutism (abnormal hair grow on body parts). The most common reason is ovarian cyst or PCOD which you have persisted for several years.

Other associated factors are stress/ anxiety/ emotional upset, hormonal imbalance including thyroid disturbance, irregular eating habit, change in body weight, taking any psychiatric medication etc.

Hirsutism and acne or pimples are appeared due to high androgen level (blood testosterone or DHEAS).

Here, you need to undergo several fresh investigations like ultrasound scan (USG) for lower abdomen to check status of the ovarian cyst, Complete hormone assay ( LH / FSH level, blood estrogen & progesterone levels), thyroid profile, repeat blood sugar & prolactin level, Blood testosterone & DHEAS level etc.

Yes, you are able to conceive but you must have to regularize your period so that your ovulation occurs timely on regular manner. Unprotected sex after marriage around ovulation time or fertile days always gives higher chance of being pregnant. Generally, ovulation occurs 14 days prior to commence next due period in regular cycle. Ovulation prediction kit (OPK) can help you to determine ovulation time.

Medical treatment is quite helpful in treating symptoms of PCOD with regularization of period. Generally, small cyst does not need any surgical treatment until it interferes with pregnancy or in case of failed medical therapy.

Here, you need to take combined drug therapy of ethinyloestradiol (estrogen) and
cyproterone acetate (anti androgen) to alleviate all symptoms including hirsutism & acne. Medication like KRIMSON-35 or DIANE-35 are widely used to treat PCOD and it is to be taken as like as regular OCP- "3 weeks on (for 21 pills) and one weeks off (to get period)".

PCOD is mostly associated with insulin resistance or hyperinsulinemia and tends to develop type-2 diabetes. Therefore, metformin 500mg (like Glyciphage) is needed to be taken with above medication to prevent the same.

In addition, you may need to take other supportive medications which are depends on fresh test reports.

You may consult with a gynecologist for proper guidance about above mentioned investigations after a physical examination.

The following measures are to be maintained for healthy life style :

1) Take healthy diet with vitamin & iron supplements.
2) Complete avoidance of salty/ fatty/ junk food stuffs XXXXXXX in high calorie.
3) Try to avoid stress by yoga/ XXXXXXX breathing regularly (20-30 times).
4) Drink plenty of water and eat more XXXXXXX vegetables & fresh fruits.
5) Control body weight by regular physical exercise. Maintain personal hygiene.
6) May need one psychological counseling. Always take a sound sleep with complete relaxation.

Hope above information is very much helpful & understandable to you. If you have any further questions I will be happy to help.

You can directly consult with me by visiting my profile on WWW.WWWW.WW and press the button "ask me a question".

Wish your good health & take care yourself.

Regards,
Dr Soumen.

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1) In PCOD, period is delayed due to anovulation associated with hormonal imbalance as well as increased level of androgen hormone due to not converting in to estrogen. There may be progesterone deficiency. Increased LH (Luteinizing Hormone) hormone is another factor for anovulation. Here, LH/ FSH ratio is generally more than 3:1.

2) After 9 months, persisting ovarian cyst or PCOD causes hormonal imbalance with anovulatory cycle, leads to irregular period again and it is not due to use contraceptive medication previously.

Using contraceptive pill (CRISANTA) does not give negative effect on your body hormone rather than it helps to correct hormonal imbalance to regularize your cycle. It is usually used to treat PCOD symptoms.

3) I am not sure about the efficacy of herbal supplement VITEX in treating your present condition. You only can rely upon medical treatment.

KRIMSON-35 or DIANE-35 is combination of ethinyloestradiol (estrogen) & cyproterone acetate (potent anti androgen) and quite effective in regularization of period & alleviating hirsutism/ acne. Laser therapy is quite useful in treating excessive hirsutism.

CRISANTA contains Drospirenone (synthetic progesterone & mild anti androgenic) and Ethinylestradiol. It is also used to treat the same.

4) Regular physical exercise & yoga for 1 hr is mandatory along with healthy diet XXXXXXX in more vegetables. Eat fresh fruits and drink more water or fluids. XXXXXXX breathing exercise is also helpful to avoid stress/ tension etc.

5) Your body weight is quite good and under control which is a positive thing. Though, you have negative family history of diabetes, you need to check blood sugar level periodically or at least 1 year interval.

6) Yes, with medical help, you will be able to conceive if cyst size is very small. Here, regularization of period is must to conceive timely.

7) PCOD only hampers ovulation and leads to infertility or problem with conceiving. After conception, it has no relation with miscarriage. So, you don't waste your time on wrong words which makes you more depressive. In case of miscarriage, other associated factors are needed to be ruled out.

8) You need medical treatment for at least 6-9 months and may be repeated depending on the status of PCOD symptoms. Life style modification is also a part of the treatment. PCOD can only be prevented by above said measures and in rare case, it is cured permanently as it may recur following complete medical or surgical treatment.

9) After marriage, sexual excitement & sex drive are usually high due to higher amount of sex hormone or estrogen level. But it can not prevent PCOD symptoms or help in regularization of your period.

Just keep faith in yourself and always think positive. You may need to undergo fresh investigations (that I have mentioned in early reply) before taking any prescribed medication (contraceptive) as supportive drug therapy may be required additionally.

Hope, I am able to clear your every doubt as per your concern. If you do not have any clarifications, you can close the discussion and rate the answer.

You can directly consult with me by visiting my profile on WWW.WWWW.WW and press the button "ask me a question".

Be well & stay healthy.

Regards,
Dr Soumen.

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