Here are a few case studies on best treatment options for PCOS given by Dr. Sangeeta Agrawal:
Case 1
An 18 year old girl came to our clinic with her mother. She had got her menarche at 14 years and since then she was getting periods only once in 3 to 4 months each one lasting for 10 to 14 days. In the last two years, she had put on 15 kilos of weight and had also noticed mild acne and hair growth on the face. Her parents were of normal height and weight and her mother had diabetes during her 2 pregnancies.
The girl on examination had a height of 5 feet 2 inches and a weight of 75 kilos. She had mild acne and facial hair. Her investigation revealed normal thyroid prolactin FSH, LH levels but slightly increased testosterone and fasting sugar. The oral glucose tolerance test was also slightly deranged. The Lipid profile was mildly elevated. Her ultrasound examination revealed features of polycystic ovaries.
We counselled her on lifestyle modification, diet control and encouraged her to increase the physical activity. She was given metformin to help reduce her sugar levels and to help her lose weight. She was given hormonal tablets to regulate her periods. She discontinued the hormonal tablets on her own after the first 6 months as she wanted to see if she could get her periods normally after stopping them. She then remained only on metformin. She has lost approximately 7 kilos in the last 2 years and her acne and hair growth is much better. Her cycles are better and come in about 30 to 40 days and last for about 5 to 7 days. Diet remains under acceptable control and she is enjoying her dance and aerobics class.
Case 2
A 27-year-old female (single though in a relationship) working in a jewellery shop came to our clinic with complaints of irregular delayed cycles and weight gain for the last 3 years. Her parents had mild diabetes and she had noticed mild acne in the last few months.
She was 165 cms in height and 80 kilos in weight. On investigations, she had normal liver kidney and lipid profiles. The hormonal profile also was normal. Her sugar levels were normal, but insulin was mildly elevated. Her general and local examination was unremarkable. She was advised to do a pap smear.
She was advised to reduce her daily calorie intake, to reduce the intake of high fat and energy-dense foods and to reduce intake of salt. She was advised to increase the intake of fruits and vegetables. We encouraged her to increase the physical activity gradually to at least 60 minutes of moderate-intensity physical activity for five days of the week.
She was given combined oral contraceptive pills to regulate periods and to provide contraception and was advised to take metformin to manage her sugar and insulin levels. Over one year she has lost weight, has regular cycles and feels good with a positive frame of mind.
