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Dr. Andrew Rynne

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Exp 50 years

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Have PCOS with insulin resistance level. Taking glycomet. Trying for pregnancy. Any advice?

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Dr. Asra Ishtiaq Ahmed

OBGYN

Practicing since :2008

Answered : 689 Questions

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Posted on Mon, 10 Dec 2012 in Women's Health
Question: hello,
I am XXXXXXX and I am having PCOS with low insulin resistance level. For low insulin resistance, I am taking glycomet 500 mg ( prescribed by doc).
Past three months, I have had periods regularly on time. But last two times, I have only spotting with no blood flow.
I am also trying for pregnancy, please advise.
doctor
Answered by Dr. Asra Ishtiaq Ahmed 1 hour later
Hello there.

Thanks for writing.

You are taking the right medication for PCOS.

I want to clarify few things.

Firstly, did you use any oral contraceptive pill in the 3 months you had regular periods.

Secondly, if you got your thyroid test done. Spotting and decreased flow could be due to associated thyroid problems.

Thirdly, did you get any ultrasound and was it normal?

It takes minimum 6 months for glycomet to show its results.

Light spotting in periods could be attributed to the PCOS problem you have.
Also in PCOS only when cycles come at irregular intervals then the bleeding is heavy else it is usually spotting which occurs.

You can meanwhile try for pregnancy. Starting a vitamin called folic acid when you are planning to conceive is also beneficial.

Weight reduction if you are overweight is the key to treating PCOS problems.
Regular exercise with balanced diet is a must to ensure this.


Kindly revert back.

Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Asra Ishtiaq Ahmed 52 minutes later
Hello Doctor, Thanks for reverting.
I was using oral contraceptive pills for two years and have stopped for a year now.
I had stopped my oral contraceptive pills in dec 11 and I got my first normal periods in aug 2012 ( after I started with glycomet tablets). I started consuming glycomet from July 2012.
The periods I got in aug 2012 was normal with proper flow. However post that, i.e., in oct and nov I have had periods but only spotting with no/less flow.
I have had tests done for thyroid - and there was no indication of thyroid.
I did have a HSG done - which was normal again - below was the statement in report
Uterine cavity is well opacified and normal in capacity and shape.
Both fallopian tubes are normal in calibre and well opacified.
There is free intra-peritoneal spill bilaterally.

I am taking Folvite MB as a vitamin tablet.
I was 58 kgs while in March 2012 and now I am 53 Kgs. So, I think I am doing okay with weight reduction as well.

I wanted to understand, if pregnancy can be normally achieved in my case ? & is spotting ( during periods) is okay, will it affect the fertility? Looking forward for your guidance.
Thanks.
doctor
Answered by Dr. Asra Ishtiaq Ahmed 3 hours later
Hello there.

Thanks for the detailed information.

Yes, pregnancy is possible.

Light periods may affect fertility if they are due to luteal phase (later half of menstrual cycle) defect.
Also if your ovulation is not proper with proper growth and rupture of follicles then it can lead to deficient hormones and infertility.
But both of these have treatment but only when the diagnosis is confirmed.

Light periods could be due to deficient progesterone which occurs in condition called luteal phase defect. Progesterone causes thickening of the lining of uterus. It is this lining which is shed in menses and supports implantation of pregnancy.
The treatment includes starting progesterone tablets in the last 14 days of your cycle. You can discuss with your gynecologist regarding their use. Also these progesterone hormone helps support early pregnancy.

You can get a follicular study(ultrasound to monitor egg size) to check if you are having proper growth and release of eggs. If it is normal, you will definitely conceive with progesterone tablet use in later half of cycle.

If the eggs are not developing proper which is common in PCOS, you can discuss with your doctor regarding the use of ovulation induction drugs(like clomiphene, letrozole) which stimulate egg development. This treatment is supplemented with progesterone in later half of the cycle which helps in achieving pregnancy.

To ensure your husband semen analysis is normal is a must before you take any kind of treatment for pregnancy.

So kindly check with your doctor these options and decide accordingly.

Kindly revert back if you have any doubts.

take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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