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Overweight with PCOD. Have hypertension. Feeling lethargic. Taking glycomet. Planning to conceive. Advice?

Sir/Mam ,
My name is Bhuvi ,33 Yrs,having PCOD since I was 17yrs old. Currrently I am suffering from overweight i.e. 103 kg with height of 5"3 inch. I have one girl child of 5 yrs old and after her birth I have gained my weight to 23 kgs and haven't been able to control it. My mistake was that I never went for proper consultation and followed up any diet and now things are worsened as I have been detected with high B.P. and I feel lathargic all the time. lately feeling very nostalgic and don't feel like eating anything and i am always feeling uneasy.
Is it because that I started having GLYCOMET 500mg SR on my gyne consultation. Plus I am taking Amlokind at of mankind for my B.P. one time in a day. To have regular periods I am also taking Diane-35/sometimes Krimson.
Problem is my husband and i want another baby in the family and we have been trying from past 2 yrs and I am unable to conceive.
I want you to guide me how should I start and what medicines I should follow so that I conceive in this year itself because I fear of my getting older for taking another chance might harm my pregnancy.
Asked On : Tue, 23 Apr 2013
Answers:  3 Views:  91
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General & Family Physician 's  Response
Hi Bhuvi.
Thanks for asking in Healthcare Magic.

Yes your weight is an issue and you have to reduce it. Your nausea is due to both Metformin and Diane. Diane contains ethinyl estradiol, an estrogen and cyproterone acetate an anti androgen with progesterone actions. Progesterone causes nausea. Diane is more suitable in PCOD with weight gain and androgenic symptoms. Metformin causes nausea, metallic taste and anorexia (loss of appetite).

In PCOD, the menstrual cycles are anovulatory. Also they are irregular. Diane regularizes the period. Metformin improves insulin action and also reduces weight. It also improves the chances of ovulation.
To improve your chances of conception, you should reduce your weight, take Metformin regularly.
Also rule out thyroid problems.

Do not worry about conception. Drugs like Clomiphene Citrate are given along with HCG to stimulate ovulation. Your treating Dr will know about these drugs. If this fails then procedures like IVF, GIFT, ZIFT and IUI are available to improve your chances of conception.

I hope this is helpful to you.
Answered: Tue, 23 Apr 2013
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General & Family Physician Dr. Achuo Ascensius's  Response
thanks for using health care magic.

Overweight/obesity complicates polycystic ovarian syndrome together with diabetes and hypertension.
For people with polycystic ovarian syndrome who are obese, the gold standard of treatment is first of all reducing weight considerably. Low carbohydrate diet or diets rich in fibre are highly recommended and include cereals whole-grain breads , whole-wheat pasta, barley, brown rice, and beans. You should limit simple carbohydrates such as soda, excess fruit juice, cake, candy, ice cream, pies, cookies and doughnuts. Also you should work closely with a dietitian and be part of regular programs for weight reduction.
Exercise is very important as well in burning up the excess calories and a sedentary lifestyle should be greatly discourage.
The two main issues of Polycystic ovarian syndrome are reduced insulin sensitivity and increase androgens. They culmilate to give the diverse complications of infertility, diabetes, hairs, cardiovascular diseases etc. Drugs targetting these two abnormalities are essential. Metformine is used to improve on insulin sensitivity and it has been proven to yield good fruits and to improve on fertility as well. Ovulation stimulating drugs like clomiphene would be beneficial as well in the case where you have ovulation problems.
You need to be followed up strictly by your doctor who should rule out other possibilities of infertility as well and put you on strict medical follow-up.

Hope this helps you and good luck.
Dr Achuo
Answered: Tue, 23 Apr 2013
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General & Family Physician Dr. Shivangi Sah's  Response
hello bhuvi,
i read your problem .first of all it is very important that you get your weight under control. join a gym and go to a dietician to follow up your plan.since you are both hypertensive and diabetic it is important that you get your weight under control...coz otherwise your pregnancy could be complicated....and check with you obgy consultant...
take care
Answered: Tue, 23 Apr 2013
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