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Dr. Andrew Rynne

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Can Primolut N Be Taken For Conceiving While Having PCOS?

Hi, i hv pcos passed from five years I married before one year, now we are trying for baby but am not conceiving getting my periods once in two months. This time I having heavy bleeding with clots.r My doctor suggested me to do endometrial d and c. But my bro in law he is also doctor and suggested to take primolut n nt to do such byapsy nw. Suggest me ?
Mon, 29 Aug 2016
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OBGYN 's  Response
Hallow Dear,

Polycystic Ovarian Syndrome is a complex disorder and needs to be managed comprehensively. This is not a disorder that causes only menstrual irregularity (which you are having). In addition there is high insulin level and high levels of male hormone, ultimately leading to complete syndrome. Syndrome is a collection of symptoms. Infertility is one of the symptom due to failure of egg release in these cases.

PCOS is characterised by many features like delayed heavy menses, infertility, obesity, growth of coarse hair on unwanted parts of the body like face, chest, legs, &c., hoarseness of voice occasionally, etc.. The lipids are high in the body threatening the cardiovascular system also. Obesity is assessed on BMI which crosses the cut off limit of 24.9.

The principles of management include obesity control with the aim of bringing the BMI to less than 24.9 by high protein, low fat and low carbohydrate diet with exercise, and regularise the insulin and male hormones levels.

Though irregular menses can be regularised by hormonal pills like birth control pills or Primolut N, they do not help in egg release and achieving pregnancy. Some egg releasing medicines like Clomiphene citrate or HMG/HGC are useful in achieving ovulation.

In many cases, only Clomiphene does not achieve ovulation induction. High insulin levels are responsible for their failure. Hence Metformin or Myo Inocitol is added to the therapy which help ovulation by controlling insulin levels. Myo Inocitol results are claimed to be better; in addition it helps controlling high male hormone also.

If all these medicines fail, ovarian drilling is performed which also gives fairly good results.

Estimation of FSH, LH, Oestrogen, Progesterone, Prolactin, AMH in blood help in deciding the mode of management. Please get these investigations done and do not go by empirical unscientific therapy.

Considering all these facts, I feel, neither D & C nor Primolut N will help you in achieving the pregnancy. Please report to an Infertility consultant to get evaluated properly and have appropriate management. Please remember, you are not interested in having only regular menses; your ultimate aim is to have successful pregnancy.

For further guidance, you may ask me direct question with uploading the reports of the investigations I have suggested and you have undergone already.

Dr. Nishikant Shrotri

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Can Primolut N Be Taken For Conceiving While Having PCOS?

Hallow Dear, Polycystic Ovarian Syndrome is a complex disorder and needs to be managed comprehensively. This is not a disorder that causes only menstrual irregularity (which you are having). In addition there is high insulin level and high levels of male hormone, ultimately leading to complete syndrome. Syndrome is a collection of symptoms. Infertility is one of the symptom due to failure of egg release in these cases. PCOS is characterised by many features like delayed heavy menses, infertility, obesity, growth of coarse hair on unwanted parts of the body like face, chest, legs, &c., hoarseness of voice occasionally, etc.. The lipids are high in the body threatening the cardiovascular system also. Obesity is assessed on BMI which crosses the cut off limit of 24.9. The principles of management include obesity control with the aim of bringing the BMI to less than 24.9 by high protein, low fat and low carbohydrate diet with exercise, and regularise the insulin and male hormones levels. Though irregular menses can be regularised by hormonal pills like birth control pills or Primolut N, they do not help in egg release and achieving pregnancy. Some egg releasing medicines like Clomiphene citrate or HMG/HGC are useful in achieving ovulation. In many cases, only Clomiphene does not achieve ovulation induction. High insulin levels are responsible for their failure. Hence Metformin or Myo Inocitol is added to the therapy which help ovulation by controlling insulin levels. Myo Inocitol results are claimed to be better; in addition it helps controlling high male hormone also. If all these medicines fail, ovarian drilling is performed which also gives fairly good results. Estimation of FSH, LH, Oestrogen, Progesterone, Prolactin, AMH in blood help in deciding the mode of management. Please get these investigations done and do not go by empirical unscientific therapy. Considering all these facts, I feel, neither D & C nor Primolut N will help you in achieving the pregnancy. Please report to an Infertility consultant to get evaluated properly and have appropriate management. Please remember, you are not interested in having only regular menses; your ultimate aim is to have successful pregnancy. For further guidance, you may ask me direct question with uploading the reports of the investigations I have suggested and you have undergone already. Dr. Nishikant Shrotri