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Have PCOS. Trying to conceive and lose weight. What treatment should be done?

Mar 2013
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Answered by
Practicing since : 1998
Answered : 5625 Questions
Hello Doc,

I am XXXXXXX Age 26, Sex F,Height 5 feet,weight 59Kgs.

I am diagnosed of having PCOS and trying to concieve, my doc has given me a dosage of 50mg siphene after which the scan on the 13th day showed the follicles had grown only upto 9mm , so my doc has asked me to go for 100mg siphene in my next cycle.
My question here is right now we are just talking only about getting pregnant but how am i supposed to treat myself for PCOS as it has a lot of side effects if not treated.what are the tests that i need to take to know the intensity of PCOS , and i need to lose some weight which i am finding it very difficult to shed some weight in spite of lot of exercises and diets ,so is there any medication for that as well.

waiting for your response

Thanks ,
Posted Thu, 4 Apr 2013 in Getting Pregnant
Answered by Dr. Aarti Abraham 1 hour later
Thanks for your query.

I congratulate you on one of the most insightful questions ever.
PCOS is a metabolic condition, and infertility is just one aspect of it.
The basic hormonal imbalance is responsible for a wide range of manifestations such as irregular periods, sub fertility, anovulation, acne, hirsutism, diabetes and other diseases like endometrial hyperplasia and endometrial cancewomen later life.

The mainstay of treatment is weight loss and lifestyle modification
Women with PCOS should not approach dieting the same way as other women trying to lose weight. Because PCOS is linked to insulin resistance, a low-carbohydrate, high-protein diet may be the most successful for weight loss. Avoid processed carbohydrates, such as pasta, cookies , pizza, maida, white bread, and get plenty of lean meats, dairy, fruits, vegetables and small amounts of whole grains.

Regular physical exercise can lead to weight loss and is particularly important for PCOS. Cardiovascular exercise can improve insulin resistance. Combine aerobic exercise, such as walking, swimming and dancing with weight training. Muscle burns more calories even at rest. However, because many women with PCOS have higher testosterone levels than average, use light weights so that you don't get bulky .

Medications can correct the underlying hormone imbalances or insulin resistance, making it easier to lose weight. Ask your doctor to consider short term birth control pills to balance your hormones, or insulin-sensitizing medications, such as glucophage, to treat the insulin resistance.

Quit smoking, drinking or other indulgences.
Avoid "crash" diets with severe calorie restriction. Use caution with traditional diet plans, as many focus on low-fat and high-carbohydrate and are therefore inappropriate for PCOS.
Eat every 3 hours , small portions or healty snacks like sprouts, curd, fruits, besan chilla etc, instead of three major meals a day.

Also your BMI is just over 25 , so technically you do not need to lose much weight.
5 kg weight loss over a period of a couple of months or three months should be your target , which should be easily achievable.

Please consult a Dietician and have a diet plan based on your age and activity level and calorie requirement.
Stick to 45 minutes of aerobic exercises ATLEAST five days a week
Ask your doctor if taking Metformin would help.

There are various drugs to lose weight, but they also have lots of side effects in the long run, and it's best to avoid them, and stick to sensible eating and exercise. It WILL show you great results in the long run, not overnight.

Also, XXXXXXX, please remember , the main culprit in PCOS is STRESS.
As long as you are stressed out and anxious, no amount of medicine or exercise will help you lose weight or to ovulate.
Please go for yoga and other recreational techniques.

Regarding test to know the intensity of PCOS, go for the following panel :

Day 2 FSH, LH, Baseline transvaginal ultrasound with ovarian volume
In addition - AMH, TSH, S. Prolactin, SHBG, DHEAS, free testosterone, fasting serum insulin, lipid profile.

I hope this helped you
Take care, and feel free to ask for further clarifications.
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