Brief Answer: PCOD is common. Detailed Answer: Hi XXXXXXX and welcome to health care magic. I am Dr Madhuri and will be helping you. I understand that you have PCOD. Every month a female egg is produced and released on day 14 of the menstrual cycle for a women with 28 days cycles. In PCOD this does not happen. This is a disorder where ovulation [ release of the female egg] either does not occur or occurs irregularly. The reason is imbalances in various hormones leading to trapping of ovum inside the ovary. Having said this the reason for you pain may be any of the following: 1. Rupture of the follicle and ovulation. This sometimes produces pain in some women. The free fluid in POD suggests a possibility of ovulation leading to pain. 2. endometriosis: where some menstrual blood gets inside the abdomen rather than coming out through the vagina. This blood forms implants there and develops just as it would have developed inside the uterus. During menstruation it sheds inside the abdomen as it cannot come out, producing pain. This is very common and difficult to diagnose. A good pelvic examination and a laparoscopy are the ways to diagnose this. 3. gastric problems: the problem may be an intestinal infection or gases that are causing pain. As of now, since you have already been diagnosed with PCOD, get a hormone testing done on day 1-2 of periods. This will help in determining which hormone is affected. If the defect is localised, targeted therapy against this hormone will lead to controlling PCOD. For the gastrointestinal cause: I suggest you begin a light diet of clear soups and simple khichdi for a few days. Probiotics like capsule vizylac twice a day will correct the intestinal bacteria and also help digestion. If there is constipation use syrup lactulose at night for a few days. They can be used without any side effects. You may take a pain killer like tablet acetaminophen to decrease the pain for now. Discuss with your gynecologist who may have examined you about the possibility of endometriosis. If she feels that this possibility is there, you may be treated for drugs that are used to help both in PCOD and endometriosis. Hope this satisfies your query. Thanks for using HCM. Feel free to ask any more questions that you may have. Dr Madhuri Bagde Consultant Obstetrician and Gynecologist

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Brief Answer: You are on the right track. Detailed Answer: Hello and thanks for the follow up query, I understand the issues now. The drugs suggested by your gynecologist are OK and you are on the right track. Ovulation study is a good investigation to look for ovulation. If it is not occurring she may give you drugs to induce ovulation in the next cycle. So this is correct management. Take the antibiotic and buscopan as they will help decrease the pain. The pain may also be due to adhesions caused by the cyst surgery or endometriosis or any of the causes explained previously. Do not think about these issues now. Since you are trying for pregnancy, just stick to it. Do ovulation study, have a husbands semen analysis as sometimes there is a defect in semen leading to problems in conception. You may need injections to rupture follicles if they are formed. So take them. If there are no results after 2-3 cycles of ovulation induction with drugs it is better to do a laproscopy to rupture the ovarian cysts and also look for any other cause of pain by laproscope. This has good results. In addition try weight loss, a healthy diet rich in fruits and low in sugar and fat and regular exercise, help to restore the hormonal imbalances and correct the problem. So best of luck. May you be blessed with a baby soon. I am always here for any more queries. Dr Madhuri

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