Brief Answer: Detailed explanation provided Detailed Answer: Hello and welcome to HCM, I am Dr Nilajkumar a consultant gynecologist and I will be helping you in your queries. I understand that your wife has pimples and the uterus is enlarged on USG. The results of the ultrasound need to be interpreted in relation to the history. The size of the uterus is big. But is she is not having any menstrual problems like frequent or heavy bleeding, then this is not a cause of concern. So do not worry about the uterus if there are no menstrual issues. The history and findings are more in favor of excess estrogen hormone. The management of these subtle hormonal imbalances is based more upon lifestyle measures like weight reduction, daily exercise, plenty of fluid intake and avoiding high fat diet. Dietary changes are very important and go a long way in the cure of acne. Ask her to eat 4 small meals in a day. The break fast must have some cereals and any indian food that she likes with low oil. Lunch at 1 pm including 2 servings of vegetable, 2 chapatis, one small cup rice, salad 2 helpings and yogurt if desired. Avoid tea coffee and other cold drinks like coke etc. A fruit in the afternoon and dinner at 7 pm similar to lunch or lesser are helpful. Variations can be tried but just try to maintain a balance of cereals and pulses, fruits and vegetables. She must avoid fat containing fried foods completely. Do not squeeze the cysts of acne as they will cause scars and also spread. Wash the face twice a day with neutrogena acne face wash and XXXXXXX dry. Use sunscreen lotion whenever she goes out. Do not use old and expired cosmetics. Drink as much water as she can to maintain hydration. Persol 5 gel must be applied to the acne at night after washing with neutrogena face wash. It must be repeated in the afternoon. It may cause some peeling of skin which is normal. Drugs to control estrogen excess are Ginette pill. This also protects against pregnancy in addition to preventing acne. It must be started on day one of menses and continued for 21 days. Stop for 7 days when a period may come and after that restart irrespective of period day at the end of 7 days. If pills are missed contraceptive benefits may not be there and may cause irregular periods. So must be taken regularly. Take it for 3-4 months. The size of the uterus may not revert back to normal once it has enlarged. But as I have already said if there are no symptoms, do not worry. I suggest that you consult a dermatologist and your gynecologist before beginning this therapy and have a prescription from them especially for ginette as other factors like blood pressure, heart etc must be evaluated before taking the pill. Hope this was helpful. Feel free to ask any further queries and I will be happy to help. Kindly close the discussion if there are no further queries. Thanks for using HCM. Have a good day. Dr Nilajkumar Bagde Consultant Obstetrics and Gynecology

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