Management of PCOD for obese women in early 30s - Dr. Sangeeta Gomes

Treatment if the overweight PCOD patients in early 30s depends on what she requires. If she is unmarried and she wants weight reduction and correction of her cycles, then start with diet and exercise, with weight loosing programmes. You can start with oral contraceptive pill with anti-androgen in it to regularize the cycle. But if she doesn’t want oral contraceptive pill, then start her on insulin sensitizing agents like metformin, berberine hydrochloride, myo-inositol and some other medications with Vitamin D, folic acid, and melatonin. Check for the hormone levels like follicle stimulating hormone, prolactin, thyroid, antimullerian hormone, complete blood count and fasting blood sugar and correction of hormonal imbalance if present. But if the requirement of the patient is pregnancy, then diet and exercise, insulin sensitizing agents, regularizing her cycles using one to two cycles of oral contraceptive pills and then go for ovulation induction and plan for pregnancy. If the fertility score is less, then other reproductive techniques like intrauterine insemination or IVF can be tried. Additional tests like hysteroscopy and lapaproscopy may be asked for to evaluate the further infertility.