Brief Answer:
Regular exercise, get insulin workup done, consult endocrinologist.

Detailed Answer:
Hello Ms XXXXXXX

Thank you for writing to healthcaremagic.com regarding your health concern.
I have read your question and understand your concern.

PCOD/PCOS is a condition that affects not only ovaries but the entire body. Since it is a hormone imbalance state, it affects all organs.

Insulin resistance is a very well recognised and studied phenomenon in PCOS, and irrespective of the obesity, people with PCOS have insulin resistance according to available literature.

It is also useful to understand that obesity itself causes insulin resistance.

This is a problem with hormonal problem, many metabolic pathways are affected and complicate one another mutually.

PCOS is diagnosed based on the following criteria,

1. Chronic anovulation,
2. Hyperandrogenism (clinical/biologic),
3. Polycystic ovaries,

As per international endocrine society, polycystic ovaries are not a must for diagnosis of PCOS.

With this background information, I would like to make the following recommendations regarding your question specifically.

1. Your Body Mass Index (BMI) is 29 and it does signify overweight.

2. Exercise is the best method to reduce fat around the belly and thighs, you need to exercise regularly (Around 1 hour every day), exercise reduces insulin resistance and also burns body fat.

3. You must consult an endocrinologist and request a complete hormonal assay including free testosterone levels, insulin level, estrogen, progesterone levels, thyroid hormones, and glucose tolerance test. This workup will allow us to guide you regarding the measures to reduce fat and also help you in future if you wish to conceive.

4. Discuss the possibility of initiating Metformin therapy for insulin resistance, because metformin reduces insulin resistance.

5. You must understand that your problem is not unique, but it is a difficult one to treat because of multiple hormones involved and requires proper understanding of the problem, hard work, and most importantly patience and perseverance.

I sincerely hope I was able to answer your question to your satisfaction, I would be happy to answer any more questions you might have ( I do think that you will have many questions, and trust me, I will do my best to answer every single question you might have).

Wish you best of health and a happy life.

Best regards

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