Brief Answer:
PCOS, treatment is correct, feedback, lifestyle changes needed

Detailed Answer:
Hi there, Dear XXXXXXX
I welcome you to HCM virtual clinic.
I have understood your concern and I will suggest you the best possible treatment options.

First of all do not panic.
I have gone through your USG reports and medical treatment details.

Your treating doctor has rightly suggested you the tablets for withdrawal bleeding.
Please finish the suggested course of Cycloreg 5 mg tablets twice a day for 5 days as suggested. Withdrawal bleeding or your periods can start within 3 to 10 days after stopping the tablets.

You can start the cyclical pills from day 3 of the cycle as suggested.
You can have 21 days tablets , followed by 7 days tablet free period.

Basically, reason for your irregular periods can be due to PCOS, as described in sonography report.
As you might be aware that PCOS is a lifestyle disorder. It needs to be addressed by adopting lifestyle changes, that include a healthy diet and regular exercise regime.

I would like to know about few things in detail.
1. What's is your current weight in kilograms?
2. What is your height in centimetres?
3. Are planning to get pregnant in the recent future? Or want to plan pregnancy a bit later on?
4. Would you like me to suggest you proper counseling and treatment of your PCOS related issues?

Your inputs will be of help to suggest you better treatment options.

Please feel free to communicate with me again.
Thanks.
Dr. Purushottam Neurgaonkar

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Brief Answer:
High BMI, lifestyle changes, medical treatment.

Detailed Answer:
Hi there.
Thanks for appreciating the answer and reverting back to me.
I have gone through your reply. It's of great help to suggest you the best possible treatment options.
From your answers, it appears to be a situation of PCOS with High BMI- means high body weight to height ratio.

As you might be aware that PCOS- polycystic ovaries syndrome is a lifestyle disorder and can be managed by healthy lifestyle changes.
In such case, ovaries show increased size and volume, also show tiny fluid filled cysts (follicles) located peripherally.
All these changes lead to absence of ovulation and hormonal imbalance.
There is weight gain, usually on the tummy, also there is unwanted hair growth in face and other body parts and oily skin and acne.
Most of the patients do have irregular menstrual period.
This can have impact on fertlity as well as on metabolic processes.

So along with medical line of treatment; which includes ovulation induction medicines and Metformin like insulin resistance lowering agents or low dose oral contraceptive pills like Krimson 35 to regulate the periods, you need lifestyle changes also.

Please opt for a healthy diet and regular exercise regimen.
Include more portions of fruits and vegetables and salads in daily diet.
Drink plenty of water in the day.
Avoid refined sugars and deep fried foods and bakery products in the diet.
Please take Iron, Calcium, protein and vitamin B 12 and Folic acid supplementation on regular basis.
This will also help as a preparation to start before getting pregnant.

Usually, cyclical pills that are prescribed for regular cycle are to be taken from 3 to 6 months in a way that 21 days of taking the tablet regularly followed by 7 days pill free period. Menstrual period starts in those 7 days. This helps to regularise the periods as well as helps to correct abnormal hormonal changes because of PCOS.


I hope this answer helps you.
Please feel free to communicate with me again.
Thanks.
Dr. Purushottam Neurgaonkar.

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