
Suggest Treatment For Severe Depression While Treating PCOS

My fear is going back on birth control pills again due to my age and propensity of headaches/migraines. I never liked the way these pills made me feel. I would feel nauseous, headachy and worry obsessively about getting a blood clot. Can you help me put my fears to rest or give advice about what to ask the OBGYN when I go back in June?
At this current time, I am battling a severe depression and I think it is tied to the PCOS. How can I help myself the best way here? I am beginning to think the cons of PCOS outweigh the pros. Thank you
As below.
Detailed Answer:
Hello
Thanks for writing to us with your health concern.
First that I have heard about the pros of PCOS - there are actually none !
Yes, depression is linked to PCOS, it is a known association.
The common link is often vitamin D deficiency.
Please get your levels checked, women with PCOS have low vitamin D levels and that increases the tendency for anxiety / depression.
PCOS is not always diagnosed by an ultrasound scan, you should have 2 out of the following 3 to qualify as a PCOS patient -
1. SYmptoms such as irregular / delayed / scanty periods, unexplained weight gain, bloating, growth of excessive hair on the chin, face, darkening of the groin, axilla, nape of the neck etc.
2. Polycystic ovarian pattern seen on ultrasound scan.
3. Biochemical levels - Get your hormones checked - FSH, LH, TSH, Prolactin, OGTT, DHEAS, free Testosterone, Lipid profile.
What is your height and weight ?
NOt having a period is the norm with PCOS, and not a concern as long as that is the diagnosis.
See, birth control pills improve PCOS, and they also regulate cycles.
If you are not comfortable with them, you might try the hormone patch or the vaginal hormone ring.
These are substitutes for the pill, and with fewer side effects.
As long as you have no ominous family history, clots should not be a serious concern.
When you go back in XXXXXXX ask for the following -
1. Confirm if you have PCOS or not, based on the symptoms, vaginal scan and blood hormone levels.
2. IF you have PCOS, it is okay to have irregular periods if you are fine with that. Simpler cyclical progesterone tablets can help to regulate periods, instead of conventional birth control pills, which you are uncomfortable with.
3. Try and let her give you a diagnosis for the absent periods.
4. Try seeking counselling for the depression, that will help. Birth control pills improve depression in some, and induce depression in some women. It is your choice.
Hope this info helped you.
Please feel free to discuss further.

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