How Can PCOS With Weight Gain Be Treated?

Hallow Doctor to be, You must be aware that PCOS is a condition which is not only restricted to Polycystic ovary due to anovulation; it is a triprong condition in which along with anovulation, there is hyperinsulinaemia and hyperandogenism. All these three dysfunctions lead to Oligomenorrhoea with irregular menses, obesity with fat deposition around the waist, development of coarse hair un unwanted areas like face, abdomen, chest, legs, etc., leonine face, etc.. Management of PCODS should aim at all theses three disorders. Obesity is one disorder which comes in way of management of PCOS. While controlling obesity, the aim should be to keep BMI under 23.9. This can be achieved by controlled diet and exercises. High protein, moderate carbohydrates and low fat with plenty of green leafy vegetables and fruits (avoid banana, chikoo, grapes, custard apple) diet should be the pattern of diet. Citrous fruits, watermelon, melon are the fruits of choice. Along with the exercises in Gymnasium, aerobic exercises like brisk walk at the pace of 90 steps per minute for minimum 40 minutes at a stretch will help you bringing down the weight. To establish a good balance between diet and exercise, please have the dietary control established and then only start exercises lest the risk of overeating after the exercises. Along with exercises, Metformin is a good medicine which can help controlling insulin levels by increasing tissue sensitivity to insulin. Latest development is use of Myo inositol in place of Metformin which helps controlling androgen levels also. The management of Oligomenorrhoea depends upon the aim to management. If immediate fertility is desired, inclusion of Clomiphene citrate or HMG/hCG is preferred. Clomiphene usage of more than 6 months is not advised. However, for a girl like you (I believe unmarried), fertility is not immediate concern. Then cyclical use of reproductory hormones would help to establish regularity of the menses. You may opt for oral contraceptive pills for this. Once you are in a stage of going for pregnancy, induction of ovulation may be considered. This is a general line of management of PCOS. For any specific advice and detailed discussion, you may ask me Direct question. Dr. Nishikant Shrotri