PCOD - best hormonal therapy?

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Sir you asked ideal harmonal therapy is nothing specific predictions of role of LH and prolactin induced activity is inviting to use Latrizole rest OCP What role they have or how much effective is not confirmed but are in use Role of metformin is in hyperinsulinemia again not established role as metformin has no direct action on insulin secretion but prescribed in doses og 850mg od for 3to6 months

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Check complete reproductive hormones. Metformin is of value if S.Fasting Insuline is elevated , otherwise 1 tab of 500 mg is sufficient. Adv.. S.AMH /S.Testesterone/S.Progesterone / S.Estrodial / S.Prolactin / Thyroid profile / Lipid Profile .. Proceed according to the findings of above investigations

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Weight reduction Tab Metformin after BSL, though very low chances hypoglycemia Very often related with hypothyroidism & hyperprolactinaemia Lab test is necessary & treat accordingly

To understand the ideal treatment, we first need to understand the problems: 1. Metabolic abnormalities: insulin resistance, hyperinsulinemia, excess hepatic and visceral fat, obesity, glucose intolerance, diabetes 2. Hormonal abnormalities: mainly increased pituitary secretion of LH, increased ovarian secretion of testosterone & androstenedione possible stimulated by both increased LH and insulin 3. Dermatologic abnormalities: acne, hirsutism, alopecia Now to treat these: 1. To reduce insulin resistance and hepatic/visceral fat: Metformin or Pioglitazone 2. To regain the hormonal balance: COC i.e., Combines (estrogen-prog) Oral Contraceptives 3. To take care of the dermatologic problems: antiandrogen - spironolactone Ideal therapy: A combination of the above three

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PCOD is characterised by insulin resistance T. Metformin 500 mg TDS is most important in treatment of PCOD

Metformin Clomiphene Letrozole Are effective options

NEED'S .. OCP .. EXPERTS OPINION ..

Latrizole Metformin

Progesterone therapy Uriplast 5 mg

Metformin

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