Brief Answer:
Please give some more information

Detailed Answer:
Dear XXXXXXX

Welcome to the Healthcare Magic Forum. I will try to advise you based on your available very short history; however, will require some more information to have a clear picture of your problem.

Your history suggests that your irregularity in the menses is more likely to be due to hormonal imbalance, though psychological stress also has to be considered; do you have any?

Menstruation is a result of failure to conceive. Throughout the cycle, the lining of the uterus (endometrium) is growing to implant and nourish pregnancy. Somewhere 14 days prior to next expected menses, egg is released (ovulation). From this point onwards, the endometrium along with growth also starts secreting for nourishment of the fertilized ovum. At this stage, the endometrium is maintained by a structure called as corpus luteum in the ovary. This corpus luteum has life of 10 days. Hence if the conception does not happen, endometrium cannot be maintained and it starts breaking after 4 days of death of corpus luteum leading to menstrual bleeding.

When, due to different causes, the ovulation does not take place, the hormonal imbalance results. Sometime hormonal imbalance leads to anovulation. Oestrogen & Progesterone are reproductory hormones while other hormones like Thyroxin also play role in deciding the menstrual bleeding.

Considering your available very short history, prima facae I feel, you could be having Polycystic Ovarian Syndrome in which the many eggs are growing but not getting released. This condition leads to delayed and profuse menstruation, Infertility, obesity with increased BMI, hairiness at unwanted places with coarse hair. I will tell you more about it after I understand some more information from you.

Please inform me:
1. What is your age?
2. Are you married or any history of sexual exposure? What is your family? Any children?
3. What is your height and weight? What is your BMI?
4. Do you have coarse hair on the legs?
5. Is there ascending tail of hair going from your private parts to the umbilicus?
6. How many days you bleed when you get menses. How many pads you have to change? Do you pass clots?

In fact, to solve your problem, I would prefer to have your pelvic ultrasonography images and reports. Would you please upload them? Also please get your blood examined for FSH & LH on 2nd or 3rd day of menses. . After viewing these report, I may suggest you few more investigations, if indicated.

I would urge you not to ignore this irregularity lest the risk of irreversible changes leading to infertility.

Meanwhile please modify your diet to high protein, moderate carbohydrates and low fat diet with plenty of fresh fruits, green leafy vegetables and milk.

To regularise your menses, you may try birth control pills for three months. They might help you. However, please do not skip the investigations I have suggested.

After I get more information I have asked for, I will be better equipped to advise you further.

If you want any more information, I am always available for you, XXXXXXX

Dr. Nishikant Shrotri

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Brief Answer:
Exercises required

Detailed Answer:
Dear XXXXXXX

Your BMI is on the higher side - which is little more than 22.7. Ideally, BMI should be under 21.9. Since you are unmarried, I presume you to be under 23 years of age. At this age you should maintaine your BMI under 20. Body weight between 64.93 and 64.95 kilograms would be higher limit of normal for you. I would advise you to maintain weight under 60 Kg.

Along with dieting, please practise regular exercises. In addition to the Gym exercises, morning & evening walk for minimum 40 minutes every time at the pace of 90 steps per minute is advocated.

Yes, the amount you are bleeding every cycle (whenever it appears) seems to be quite high. Please get your Haemogramme done to find out the degree of anaemia you have, if any. Irrespective of haemoglobin percentage, please start iron tablets at least 3 times a week.

I am awaiting for the results of the investigations I have suggested. XXXXXXX age does matter in arriving at diagnosis and planning the management.

As I have suggested, you may start with birth control pills for regularising the menses temporarily. After having a look at the report, I may suggest you some different treatment.

For any more information, please feel free to ask me any time, XXXXXXX

Dr. Nishikant Shrotri

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Brief Answer:
Diet & Exercise

Detailed Answer:
Dear XXXXXXX

I have already given you few tips in my previous communications for weight reduction.

You have to follow two principles:

1. Control over the diet: Try to plan only 1000 - 1500 calories per day. These calories should be more from the proteins and least from the fats. Fats should be only to fulfill the lag of the calories. Consume at least 500 gms of Proteins and 500 gms of carbohydrates every days. Instead of having sumptuous food at two times, divide you feeds in 6 feeds at 3 hourly interval.

2. Once you are confident of control over the diet, then start exercises. You can do stretching exercises in the Gym or at home. Swimming is one of the best option for this. In addition to that walking in the fresh air just before the sunset and after the sunrise will help you even to have a control on hyperinsulinaemia which is present in PCOS.

PCOS and Obesity are the cause and effect of each other. It then becomes a vicious circle. So please do not ignore the investigations. Please upload the rest of the reports at the earliest.

You may ask for any more information. I will always be answering them, XXXXXXX You may think of posting a good review with 5 starts if you feel so.

Dr. Nishikant Shrotri

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