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Suggest Treatment For PCOS, Hairfall And Acne
Question: I'm 35 and was diagonized with PCOS last year in Aug'13..My gynae had prescribed Ovanac plus twice a day continous, which I took for 2 months and is now having regular periods, however I started gaining weight (almost 7 kgs in this period), there is also lot of hair fall, acne eruptions and patches on skin (acathosis nigrecans). I lately consulted an endocrinologist who have diagonized me with insulin resistance (based on a number of test reports including Lipin profile, Hb1ac, Thyroid complete, hormone complete test, ultrasound of the uterus) and have prescribed CetapinXR 500 mg, evion 600. I want to confirm whether I should continue with Ovanac plus even if i"m taking CetapinXR 500 mg. Also how these medicines are going to treat the ailment.
Brief Answer:
Continue all medications
Detailed Answer:
Hi XXXX
Welcome to HCM. I had gone through your question and understand your concerns.
Polycystic ovarian syndrome is a combination of irregular cycles, increased male hormones (acne, facial hair) and polycystic ovaries in ultrasound. If you have any two of these you are having PCOS.
Obesity and insulin resistance can also present like PCOS.
I have gone through your reports. Nothing to worry. I think we will start with basic things first. You should start exercising regularly - at least 20-30 minutes brisk walking a day covering 3-4 kilometers a day regularly - at least 6 days a week. Have frequent low calorie, high fiber diet with plenty of water suiting your eating habits. Avoid refined sugars, soft drinks and fried items.
Since you have acanthosis and obesity you were started on Cetapin XR which will decrease your insulin resistance and will help to reduce weight. To regularize the cycles the first line drug is oral contraceptive pills - and Ovonac plus will help the cause along with metformin (Cetapin XR). It will help you to reduce the acne and hair fall. But the problem is moderate weight gain.
So my suggestions are:
1. Continue metformin (Cetapin XR)
2. Restart Ovomac and continue for next 3-6 months and let your Gynaec /Endocrinologist make a call on the duration of treatment
3. Most important - lifestyle changes - Exercise and diet control
Hope I have answered your question. If you have any further questions I will be happy to help.
Regards
Dr Ajish TP
Consultant Endocrinologist
Continue all medications
Detailed Answer:
Hi XXXX
Welcome to HCM. I had gone through your question and understand your concerns.
Polycystic ovarian syndrome is a combination of irregular cycles, increased male hormones (acne, facial hair) and polycystic ovaries in ultrasound. If you have any two of these you are having PCOS.
Obesity and insulin resistance can also present like PCOS.
I have gone through your reports. Nothing to worry. I think we will start with basic things first. You should start exercising regularly - at least 20-30 minutes brisk walking a day covering 3-4 kilometers a day regularly - at least 6 days a week. Have frequent low calorie, high fiber diet with plenty of water suiting your eating habits. Avoid refined sugars, soft drinks and fried items.
Since you have acanthosis and obesity you were started on Cetapin XR which will decrease your insulin resistance and will help to reduce weight. To regularize the cycles the first line drug is oral contraceptive pills - and Ovonac plus will help the cause along with metformin (Cetapin XR). It will help you to reduce the acne and hair fall. But the problem is moderate weight gain.
So my suggestions are:
1. Continue metformin (Cetapin XR)
2. Restart Ovomac and continue for next 3-6 months and let your Gynaec /Endocrinologist make a call on the duration of treatment
3. Most important - lifestyle changes - Exercise and diet control
Hope I have answered your question. If you have any further questions I will be happy to help.
Regards
Dr Ajish TP
Consultant Endocrinologist
Above answer was peer-reviewed by :
Dr. Bhagyalaxmi Nalaparaju
The weight gain is mostly around the abdominal, I have been exercising regularly in the gym (atleast 5 days a week for an hour) for the last two months but the abdominal fat is not dissolving easily. These medicines are going to work on the abdominal fat as well.
Also, along with hairfall the texture has become rough. There are dark patches on the faces which has though started fading ever since I took metformim.
Will all these ailments be treated with the medicine currently prescribed.
Also, along with hairfall the texture has become rough. There are dark patches on the faces which has though started fading ever since I took metformim.
Will all these ailments be treated with the medicine currently prescribed.
Brief Answer:
Stop Ovomac if weight gain is not improving
Detailed Answer:
Hi XXXX
It is great that you are following good physical activity. Continue same.
The weight gain - especially abdominal obesity is difficult to control and it takes longer time to control. Oral contraceptive pills used for PCOS will cause weight gain. If it is creating problem discontinue using that.
Metformin will have moderate weight loss and improve your insulin resistance. So continue that. To be XXXXXXX weight loss with metformin is only moderate and we don't have medications to decrease without side effects to decrease weight. So have faith in exercise, diet modification and metformin and hope for best results.
Please consult your doctor and check if you have vitamin deficiencies. B complex vitamins, vitamin D and zinc are helpful improving hair texture and growth.
Wishing you good health.
Regards
Dr Ajish TP
Consultant Endocrinologist
Stop Ovomac if weight gain is not improving
Detailed Answer:
Hi XXXX
It is great that you are following good physical activity. Continue same.
The weight gain - especially abdominal obesity is difficult to control and it takes longer time to control. Oral contraceptive pills used for PCOS will cause weight gain. If it is creating problem discontinue using that.
Metformin will have moderate weight loss and improve your insulin resistance. So continue that. To be XXXXXXX weight loss with metformin is only moderate and we don't have medications to decrease without side effects to decrease weight. So have faith in exercise, diet modification and metformin and hope for best results.
Please consult your doctor and check if you have vitamin deficiencies. B complex vitamins, vitamin D and zinc are helpful improving hair texture and growth.
Wishing you good health.
Regards
Dr Ajish TP
Consultant Endocrinologist
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Shanthi.E
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