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Suffering from PCOD problem. Effective medicine to regulate period?

Mar 2013
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Hi Doctor,

I am suffering from PCOD problem. I couldn't find a suitable gynaecologist to treat this. Could you please guide me through the right medication to be taken to make my periods regular?

Posted Fri, 22 Mar 2013 in Women's Health
Answered by Dr. Aarti Abraham 5 hours later
Thanks for your query.

PCOS is a common condition affecting about 15 percent of reproductive age women. Women with PCOS have a higher risk than normal to develop diabetes, heart disease, and uterine cancer. Furthermore, PCOS women who get pregnant run the risk of developing gestational diabetes, fetal demise, and many other pregnancy related complications. Finally PCOS does interfere with fertility, impairing normal fertility.

PCOS is a syndrome with symptoms that to date still creates much debate among academicians. For example, the criterion was recently changed to add the appearance of multiple cysts (antral follicles) in the ovary diagnosed by ultrasound. The diagnosis of PCOS, for now, is the exclusion of other conditions with two out of the following three symptoms present:

1. No periods or few periods in a year

2. Increased blood “testosterone” levels or the appearance of excess body hair growth

3. Multiple ovarian cysts (better stated as antral follicles less than 12mm) seen on ultrasound.

There is a hereditary pattern associated with PCOS that has been recognized, predisposing some people to get PCOS more than others. In our overweight population, the increased fatty tissue primarily around the abdomen creates insulin resistance. The body needs to create more insulin then to override this resistance because insulin is needed to utilize the sugar/carbs we eat. No insulin equals no energy. This excess insulin now keeps the ovary from ovulating, stimulates it to produce more testosterone, and diminishes the liver’s production of proteins needed to “clean up” testosterone. If the resistance is severe and prolonged, the body will eventually stop making an adequate amount of insulin; sugar builds up in the blood and gets excreted in the urine (diabetes).

The most common symptom noticed from PCOS is from the excess testosterone floating around the body. This will cause an increase in hair growth (hirsuitism) that will be present in the lower abdomen, a lateral extension of pubic hair, increased lower back hair, mild facial hair and acne. Since the ovary is not able to ovulate due to the excess insulin, skipped or missing periods will also be noted. In more severe cases, a skin condition from excess insulin called acanthosis nigricans can develop on the back of the neck, breasts, under arms (axilla), and groin. The skin appears thickened and much darker in those areas than the rest of the body.

A big cause for infertility in PCOS patients is their inability to ovulate, but even if ovulation is stimulated with medications, pregnancy rates are still lower than individuals without PCOS. This means there are other factors contributing to infertility than just not ovulating.

When one doesn’t have periods because of PCOS, the endometrium (tissue inside the uterus) can convert into cancer. Not only that, one can eventually develop hypertension (high blood pressure), high cholesterol, heart disease, and a multitude of other health problems.

Weight loss to diminish the amount of extra fatty tissue is always the first and best recommendation that can be given. Indeed, even a 5 percent drop in some cases may be enough to restore one’s menstrual cycles. If weight loss is not an option and one is willing to undertake pregnancy risks, then ovulation induction can be performed. Metformin is used to regulate periods and overcome insulin resistance.

Weight gain will cause PCOS to worsen. It is important, therefore, to always maintain a healthy diet and exercise.

In your case, XXXXXXX 35, or oral contraceptive pills were given, as they regulate the disturbed hormonal picture, and help in regular periods. However they are not a permanent cure for PCOD.
Consider starting Metformin, and plan your pregnancy and conceptions early ( do not delay too much ) , as you might need treatment for that also.
Recently, a new drug called Oosure plus has been proven beneficial in PCOD patients .

For reputed doctors in your city ( Bangalore ) , I suggest the following links , please go through them :

You can also consult Cloud Nine Hospital or Manipal Hospital

Take care, and wish you all the best.
Feel free to ask for further clarifications.
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