ASK THE DOC
Dr. Sharda Jain, Senior Consultant Gynaecologist, National Commission for Women, New Delhi, replies to this week's queries.
MY daughter is 18 years old. She has facial hair. The doctor advised a hormone test and the result was Follicular stim. Hormone (MEIA) 4.6; Luteinising hormone(MEIA) 12.3; DHEAS-197; Free testosterone (RIA) 2.8. Will this affect her fertility? What is the treatment? Name withheld
Answer: Hirsuitism (increased facial hair) is a common problem in young girls. You have not written about her menstrual cycle. Are they irregular or delayed? Her hormones also show change in FSH:LH ratio. See good gynaecologistst without delay. Hair growth can be arrested, but it takes nine months to one year with treatment. Once the growth stops , extra hair can be tackled with Laser treatment.
MY daughter is 14 years and six months old now. She attained puberty when she was 12 years 8 months old. But her periods were very irregular. We consulted a gynecologist and on her advice hormone treatment was given for 21 days. The hormone treatment was supplemented with an iron tablet (Rescafe) and an ayurvedic tonic (Evatone). The second course of treatment was to start on the fifth day of menstruation, but could be started only on the eighth day. Since it was three days late, the treatment was given for 18 days instead of 21 days, as advised by the gynaecologist. However, this time she did not menstruate. Fearing ill effects, the hormone treatment was discontinued. The iron tablets and the ayurvedic tablets are continued. Now, two months have passed and she has not yet had her periods. Please advise. Alexander
Answer: Your daughter probably has polycystic ovarian disease. She needs to see an experienced gynaecologist. A pelvic ultrasound is needed to confirm the diagnosis of PCOD. Check her baseline hormone levels and weight and then treat her in systematic way. Also help her reduce her weight if she is overweight.
I AM 17 years old. I think I suffer from Polycystic Ovarian Disease although I have never been diagnosed. I seem to have some of the symptoms and I think it runs in my family. My sisters also have it. Over the past few years, my facial and body hair has increased. It's getting quite bad and I am too embarrassed to see a doctor! My periods are very irregular. Name withheld
Answer: Yes, it seems you have polycystic ovarian disease. Before your periods and hair growth get worse, do seek the advice of a good gynaecologist experienced in treating adolescent girls with PCOD.
I AM 28 and have just recently been diagnosed with polycystic ovarian disease. It has been theorised that I may have endometriosis. My doctor put me on Ovcon, which is a birth control pill and told me to take it without stopping so that I will skip my periods. I don't seem to have the normal symptoms such as facial hair or extreme weight gain but I do have mild acne and cysts that seem to burst every month which are very painful. I am wondering if there is anything I can do differently or more since I still have bursting cysts and discomfort throughout the month even on the pill. If my hormones are out of balance what can I do? I know there is a drug that can put you into early menopause but I don't want to go to that extreme. Christina
Answer: Polycystic ovarian disease and endometriosis are two different problems. It seems endometriosis is causing you more trouble, with pain and discomfort in pelvis even when you are on the pill. This needs confirmation by a laparoscopic examination. Simultaneously you can be treated with laparoscopy.
I DELIVERED in the 30th week of pregnancy. My baby died after four days. Some said he had neural tube defects. Before marriage I had polycystic ovary and while being treated for that, I reduced my weight from 89 kg to 69 kg . Now I am 24 years old. My height is 5 ft. 6 in. and weight is 86 kg. A thyroid test showed subclinical hypothroid. I am taking thyrox for past one month. I am also following a diet and doing exercise. Please tell me if this will affect my chances of pregnancy or affect the baby if I conceive. Prema
Answer: Don't get depressed by this mishap of pre-term delivery and death of your baby. Reduce your weight further, continue treatment for hypothyrodism and try pregnancy six to eight months following previous delivery. Better care will see you through. Polycystic ovaries do not cause pre-term delivery.
IN August 2002, I was diagnosed with endometriosis. I underwent surgery in March 2003, I have had a pelvic ultrasound done. The result states my uterus is anteverted and enlarged by intramural fibroids. My endometrial stripe is normal, my right ovary is also normal but there is a cyst is in my left ovary. However no free fluid was seen. With T4 of 6.6, TSH of 1.3, FSH of 4.8, LH of 6.9, Testosterone of 43.7, Oestradiol of 1.0 and Progesterone of 12.6. Is there any chance of me ever getting pregnant? My husband and I are very desperate, we cannot afford IVF at present; are there any other options? If not, I would like to remove all that is causing me all this pain during my monthly cycle. I will be 28 in May; my husband is the same age. Mitsy
Answer: It is clear you have problem of recurrence of endometriotic cyst and multiple fibroid in addition. You do need IVF, but another surgery will be needed to remove two fibroids before IVF can be tried. Another option is that you could adopt a child.
I AM 20. My menstrual cycle was irregular. I under went a scan; it was found that bilateral enlarged and hypo echoic ovaries with small cysts. I take every month dydrogesterone tablet 1p(duphaston) for past three years. Now my periods are regular but I have facial hair. I had excess weight when periods were irregular but I took diamet 850 but stopped after one year. Do I have to continue with the medicine? Priya
Answer: You are suffering from polycystic ovarian disease, with obesity and facial hair growth. Your doctor needs to reassess and guide you about Diane 35 and spironolactane. Once your hair growth is stabilised with this then laser treatment can be done. You have to reduce your weight and maintain it.
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