Brief Answer:
Proper investigation and management.

Detailed Answer:
Hello,

Thanks for writing to us.

PCOD is the commonest hormonal disorder found in the reproductive age group. Several hormonal imbalances can co-exist and treatment is almost always possible.

In your case, which is the typical presentation for PCOD, I would suggest a proper work up with an endocrinologist along with a gynecologist. You need a complete hormonal profile, glucose tolerance test, AMH, serum DHEAS levels, serum Prolactin levels etc.

As per your sonogram report, the uterus is normal and the ovaries show the typical picture of PCOD. Pain during intercourse could be due to the cystic ovaries which can prolapse into the Douglas' pouch.

Treatment should be guided by the investigations and aim at controlling the hormonal imbalance specific for the condition.

Metformin is useful in controlling insulin resistance usually associated with this condition and helps to induce ovulation. Other hormonal imbalances are also to be managed well. Weight management and some form of regular exercise like skipping help to keep the weight gain under control and also help to correct the menstrual irregularity in a significant number.

After complete evaluation, cycles are initially put on track through use of combination pills for a few cycles followed by ovulation induction under monitoring if you are anxious to conceive. Sometimes, priming by low dose dexamethasone for three months prior to ovulation induction usually gives quick results.

You should also check the need of using maintenance doses to keep your thyroid profile normal.

Finally, I would like to say that so many things are available in the management and the outlook is very good.

Hope I have clarified your query. Please feel free to contact for further clarifications. I will be happy to help.

regards,
Shanti.V.

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