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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For PCOD With Hypothyroidism

Dear Doctor, I am unmarried, 22 years of age with 145 cms height. I had been gaining weight since a while but didnt give much care about it. But I finally noticed that I gained 10 kgs in two months. I was under medication for hypothyroidism and was consuming Thyronorm 75mg since last September. The recent TSH test showed that I m hyperthyroidic. The doctor reduced the medication to 50mg. I also had a Pelvic scan. The details are given below. Uterus in anteverted, normal in size, centrally positioned and regular in outline. It measures (6.6 x 5.3 x 3.4)cm-nulliparous size. Myometrium appears normal, no obvious focal lesion seen. Endometrium is central, well defined, thickened and measure 12mm. Both ovaries are bulky in size but normal in echoappearance. Multiple small follicles are seen lined along the periphery on both siides. Mild increase in the ovarian stroma is noted on both sides. Rt ovary measures (3.0 x 2.7 x 2.7)cm, with a volume of 11.0 cc. Lt ovary measures (3.3 x 2.2 x 2.8)cm, with a volume of 10.7 cc. No obvious adnexal mass seen on either side. Cervix is normal. Small amount of fluid is seen in POD - reactionary. Impression : Finding are suggestive of B/L Polycystic ovaries. Hormonal correlation is recommended. Please advise on what am I supposed to do. I am currently working and am in stress both due to work and bad physical health. I frequently develop colds, shivering, dizziness, stomach aches and ear imbalance. I always feel exhausted and tired. I have irregular periods and vaginal discharge daily. At times I do have vaginal discharges with blood traces.
Wed, 17 Feb 2016
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General & Family Physician 's  Response
Thank you for your query

Polycystic ovarian disease is a disorder that arises due to an imbalance of hormones. Usually, in a regular menstrual cycle, a few eggs from each ovary are recruited to develop, out of which one (the dominant follicle) will ovulate and the rest either become atretic (die away) or support the dominant follicle hormonally.
The dominant follicle then forms the corpus luteal which remains for upto 2 weeks or longer (if pregnancy occurs). If no pregnancy results, the corpus luteal dies off and period occur within 24 hours.

In Polycystic ovaries, the cysts are frozen in the development stage and no dominant follicle arises and regular ovulation does not happen. This leads to build up of hormones and weight gain, irregular periods and increased discharge under the influence of the increased hormones (estrogen). It can also lead to infertility issues. The build up of endometrial tissue under the prolonged influence of hormones can lead to a heavy lining which may be she'd due to sheer weight which would explain why you have blood stained discharge at times.

Fortunately, there are measures that you can undertake to improve your symptoms (exercise, weight loss, avoid environmental sources of synthetic estrogen like plastics, food storage package materials for instance.

Good control of your thyroid is also important. Your doctor will advice you on this

Your symptoms of dizziness, ear imbalance are a little out of place in this setting. I would like to rule out vertigo, ortho static hypotension.

Hypothyroidism can cause symptoms of shivering, fatigue, hair loss and reduced immunity.

I recommend a consult with a Reproductive endocrinologist, physician, Obgyn team.
Treatment will be aimed at regulating your hormones, weight loss, and improve lifestyle.

I suggest exercise (if you can do 10 minutes, do it, better than no exercise) healthy diet (include lots of greens and fresh fruits, dried fruits and nuts). Avoid processed foods Slowly increase your exercises. Even a loss of 2kg will help your symptoms and your energy levels.

If and when you decide to get pregnant, you will need to regulate your cycles to improve chances of conceiving. This usually needs medications, if your cycles are irregular or if you have not conceived within a year of trying with regular interiors.

Hope I've answered all your queries and helped a little with reassuring you.

Please let us know if you have any questions. Wish you good health
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Suggest Treatment For PCOD With Hypothyroidism

Thank you for your query Polycystic ovarian disease is a disorder that arises due to an imbalance of hormones. Usually, in a regular menstrual cycle, a few eggs from each ovary are recruited to develop, out of which one (the dominant follicle) will ovulate and the rest either become atretic (die away) or support the dominant follicle hormonally. The dominant follicle then forms the corpus luteal which remains for upto 2 weeks or longer (if pregnancy occurs). If no pregnancy results, the corpus luteal dies off and period occur within 24 hours. In Polycystic ovaries, the cysts are frozen in the development stage and no dominant follicle arises and regular ovulation does not happen. This leads to build up of hormones and weight gain, irregular periods and increased discharge under the influence of the increased hormones (estrogen). It can also lead to infertility issues. The build up of endometrial tissue under the prolonged influence of hormones can lead to a heavy lining which may be she d due to sheer weight which would explain why you have blood stained discharge at times. Fortunately, there are measures that you can undertake to improve your symptoms (exercise, weight loss, avoid environmental sources of synthetic estrogen like plastics, food storage package materials for instance. Good control of your thyroid is also important. Your doctor will advice you on this Your symptoms of dizziness, ear imbalance are a little out of place in this setting. I would like to rule out vertigo, ortho static hypotension. Hypothyroidism can cause symptoms of shivering, fatigue, hair loss and reduced immunity. I recommend a consult with a Reproductive endocrinologist, physician, Obgyn team. Treatment will be aimed at regulating your hormones, weight loss, and improve lifestyle. I suggest exercise (if you can do 10 minutes, do it, better than no exercise) healthy diet (include lots of greens and fresh fruits, dried fruits and nuts). Avoid processed foods Slowly increase your exercises. Even a loss of 2kg will help your symptoms and your energy levels. If and when you decide to get pregnant, you will need to regulate your cycles to improve chances of conceiving. This usually needs medications, if your cycles are irregular or if you have not conceived within a year of trying with regular interiors. Hope I ve answered all your queries and helped a little with reassuring you. Please let us know if you have any questions. Wish you good health