PCOS management
Dear Dr Mitchell,
I was in the process of researching Polycystic Ovary Syndrome (PCOS) online and I came across your articles. I am 19 years old and I struggled previously with my weight. By about the age of 17 I went from 195 to 150 pounds. However, in the last two years, more prominently in the last two months, I have gained a little weight especially in the thigh and abdomen area. After an ultrasound it was determined that I have polcystic ovaries even though I do get a period every month. I also do have seriously excessive hair on my face, neck, chest and abdomen as well as severe hair loss on my head. My doctor has put me on the Dianne 35 pill as well as Metformin. I do exercise about three to four times a week; however, I have not made any drastic changes to my diet. I’ve been on the birth control pill as well as Metformin a little over one month now. I have not noticed any significant weight loss, about two to three pounds. Neither have I noticed any gain. My current weight is 160, however, I am 5ft 10 inches. I have a healthy BMI of 23, however, physically I am noticing a lot of weight gain. Will the combination of these two pills eventually lead to weight loss? I know it takes a couple of months for the tablets to really get into your system and enable you to see a change; however, I fear the possibility of taking them and not noticing any changes.
The problems that you have as a result of the polycystic ovarian disease are definitely being managed properly. The use of the Metformin and Diane 35 tablets will regulate the period, reverse the peripheral effects of the excessive male hormone (testosterone), and control your weight.
Weight loss of two to three pounds over a month seems like a slow process, but this will require patience. Losing weight will be over a long period of time and keeping the weight off will require a lot of discipline to stick with the diet and exercise programme. In the long term, achieving your ideal weight for height will reduce your risk of developing diabetes mellitus, improve your fertility, and reduce your risk of cancer of the uterus in your later years.
The excessive hair growth on the face and body (hirsutism) usually will take several months on the Diane 35 to see a significant reduction. The effect on improvement in acne is usually seen a lot earlier than the reduction in body and facial hair. In the interim you can remove excessive facial and body hair by shaving, plucking, electrolysis, waxing or by laser hair removal. The use of Diane 35 in addition will slow down the regrowth.
You will be able to discontinue the Metformin if the menstrual cycles are regular and you have achieved your ideal weight for height. When you are older and decide to try for a pregnancy you can restart the Metformin and discontinue the Diane 35. Clomiphene Citrate (Clomid) when used with the Metformin will also help to improve your fertility. It is important to stay on the Diane 35 if you are sexually active, because once you lose weight your fertility will improve and the Diane 35 will prevent an unwanted pregnancy. The use of condoms (male or female) in addition to the Diane 35 will prevent sexually transmitted infections, such as HIV. Best wishes.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 968-2025. All responses are published. Dr Mitchell cannot provide personal responses.
DISCLAIMER
The contents of this article are for informational purposes only and must not be relied upon as an alternative to medical advice or treatment from your own doctor.
