Hello dear Curofians, I would like suggestions regarding following case: 17 yrs old girl presented with irregular cycles since menarchae. M/H : 3 to 4 days once in 45 to 75 days, decreased flow with mild pain. No history of any major illness. On examination, obesity+, 62.5 kg, height 5.1 feet, BP:110/80 mmHg, no galactorrhea. USG normal. No PCOS seen on USG.
vasundhara, the lab reports show normal blood sugar. FSH,LH, normal. DHEAS RAISED(raised in PCOS). PROLACTIN RAISED. MILD HYPOTHYROIDISM. irregular cycles, obesity, raised DHEAS all point to PCOS. *lifestyle management. *exercise. *treat hyperprolactinaemia with tab cabergolin 0.5 mg /week. *give tab thyronorm 25ucg /day. *ocp's can reduce DHEAS thereby the androgenic features are reduced. *ocp's also regularize menstrual cycles. as this case fulfills two out of three Rotterdam's criteria,i feel she is a case of PCOS. *are there any signs of hyperandrogenism like acne,hirsutism,acanthosis nigricans
DEAR MADAM I HAVE SEEN THE REPORTS OF THE CASE EXCEPT DEHYDROEPIANDRO STERONE DHEAS AND MILD HYPER PROLACTENEMIA AND SUB CLINICAL HYPOTHYROIDISM , ALL OTHER FACTORS ARE IN OUR FAVOUR .DYSMENORRHOEA , MADAM YOU HAVE ALSO REPORTED . ACTUALLY WITH THE PASSAGE OF TIME IT WILL COME TO NORMAL OBESITY TO BE CONTROLLED .HYPO TYHRODISM TO BE TRATED .HYPER PROLACTINAEMIA SHOULD BE TREATED WITH BROMOCRIPTINE ..
As for age of the case correction of anaemia, deworming. dietary supplement. .If it persists start low micronzed comb pill like femilon one tab from 5th day of mc for 21 days for 3 cnsequtive cycles. .follow up & review. ..
Reduce her weight. Give cabergoline 0.5 mg weekly for 3 months and monitor prolactin values. Start metformin 1000mg daily . Initially start with 500mg daily . Start Ashokarista and dashmularsta . Medari guggul . Regular exercises and swimming exercise if feasible will help to reduce her wt. Please do lipid profile .
Rule out anaemia, advised deworming as nutritional anaemia is very common in INDIA.
treat Hyperprolactinemia with carbergoline .5 weekly, ,LSM, ,WEIGHT REDUCTION, ,TAKING PLENTY OF FLUIDS,,GREEN LEAFY VEGETABLE, ,
what about thyroid profiles madam?. anemia? advise physical activity. diet control. hyponid tab. Will be useful. iron rich foods like dates, Palm jaggery, figs, green leafy veggies to be taken.avoid cauliflower, spicy oily foods. tab. aloes compound also gives positive results.
Weight reduction evecare syrup ocp
advice regular exercise,yoga and swimming exercise for reduce her weight. agree with Dr suvarchala mam
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