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Have PCOD and irregular periods. Getting nausea, backache and cramps. Noticed spotting. Took duphaston. Chances of pregnancy?

Mar 2013
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I am TTC for last 2 months. Also have pcod and very irregular cycles. In May as well as XXXXXXX just about 4-5 days before periods are due, I start getting nausea, backache, cramps. Pregnancy tests have been negative, and what starts is Spotting and brown clots, randomly. In May i took duphaston for 5 days to have proper periods, but they were very light, with mostly mucus and clots, and lasted for 3 days. This month i cant understand if I should take duphaston to have periods or let clots continue. Before this, although my cycles were irregular, but bleeding has been heavy. What are my chances of conceiving? I am in dilemma about my periods. Please help.
Posted Tue, 16 Jul 2013 in Pregnancy
Answered by Dr. Aarti Abraham 35 minutes later

Thanks for your query.
ovary-syndrome/0000" >PCOD or polycystic ovarian disease, is a condition characterized by irregular periods and irregular ovulation.
The ovary gets studded with multiple small follicles, and none of them mature every month to produce a mature egg or ovum, and hence there is difficulty in having regular cycles and in ovulating.
There is a basic hormonal imbalance, and there is alteration in ratio of the FSH and LH levels. ( even though individual hormonal level measurements may be normal )
Due to hormonal imbalance, there is build up of the lining of the uterus, which gets shed off irregularly, leading to delayed and heavy periods, and at times, only clots and brown spots.
Also, there are other features such as hirsutism ( increased hair growth ), skin pigmentation, raised blood sugars etc.
Apart from FSH, LH, TSH, the following investigations should be done -
1. LH, FSH ratio, Adrenal hormones like DHEAS and free testosterone, serum prolactin, glucose tolerance test, fasting serum insulin.
2. There is no XXXXXXX cure XXXXXXX for PCOD, only the symptoms may get better with treatment. If you are overweight / obese, then diet and lifestyle management is the key to treatment. Even a 5 % weight loss leads to improvement in period patterns.
3. Metformin is helpful in relieving the condition, so take it as prescribed.
4. You might not have regular periods, or you may have them occasionally, and sometimes in response to progesterone therapy ( Duphaston ). Do not take duphaston on your own though. Please take it on prescription, and there is no harm in taking it to regulate your cycles.
5. Do not be frustrated by the irregular cycles. Women with PCOD sometimes need help of medications like clomiphene citrate or other higher drugs in order to have proper ovulation and conception. In-spite of all medical management ( weight loss, progesterone, metformin ), if you fail to conceive after a few months, you can consult an Infertility Specialist and consider starting clomiphene citrate.
Before starting clomiphene, your husband's semen analysis should be tested, also after 2 - 3 cycles of clomiphene, or even before that, you can have testing in the form of laparoscopy to check if your fallopian tubes are open.
6. Take regular folic acid supplements when trying to conceive.
7. Have your vitamin D levels checked, as women with PCOD often have vitamin D deficiency.
8. Do not stress yourself out unnecessarily. Lighten your stress levels, take a vacation, start doing yoga, because stress is the main culprit in deranging the normal hormonal levels.

Take care, and please feel free to discuss further.
All the best, XXXXXXX
Above answer was peer-reviewed by
Follow-up: Have PCOD and irregular periods. Getting nausea, backache and cramps. Noticed spotting. Took duphaston. Chances of pregnancy? 34 hours later
Thanks Doctor. I also wanted to know if I am taking Duphaston to get regular periods, does that also mean I am ovulating on the day as in normal cycles? Also how many months do you suggest I wait before starting the Clomiphene treatment. This was 2nd month TTC.
Answered by Dr. Aarti Abraham 57 minutes later
Patients with PCOD have difficulty in ovulation, as I mentioned before.
Duphaston is given to regulate the endometrium and induce regular bleeding, it does not ensure ovulation.
Normally, patients with difficulty in conceiving are asked to wait for a year of unprotected intercourse, before proceeding for investigation and treatment.
Given the existing condition of PCOD, I would suggest that you go for further treatment after 6 months of unprotected intercourse.
Above answer was peer-reviewed by
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