Sunday, January 12, 2014

Principles for Self Management of PCOD and Infertility


Poly cystic Ovarian Disorder is a common cause of infertility. It is a disorder of the ovaries which leads to irregular menstrual cycles. These patients need regular cyclical treatment every month to help get their regular menstrual cycle. Most of these patients are unaware of the details of the disease and how to manage it. The associated fear of infertility worsens their mental stress. Some doctors try to cash in on this ignorance and ask the patient to come in every month for a dose of hormones.

PCOD patients who are infertile often suffer because of their ignorance, more than their hormonal imbalance. We, at Malpani clinic, ensure that every patient is informed about the disease, its implications and self management principles. Here are a few basic principles that may help patients in self management , and reduce their stress of frequent visits to the doctor.

Firstly, the patient needs to understand what PCOD and what its consequences are. Hormonal imbalance and irregular periods go hand in hand with PCOD. It is better that patients schedule their monthly dose of progesterone hormone themselves, so they get regular periods. Otherwise, the missed period every month creates false hopes and prompts them to undergo a pregnancy test, and a failed pregnancy test causes stress and leads to a doctor visit.

In these cases it is better to be proactive than reactive. Our advise is thatyou do a pregnancy test on the first of every month. If it comes back negative, then you should start your regular dose of medication to induce periods. The normal treatment for inducing periods is to take progesterone medication. This is medroxyprogesterone acetate, and is available in the market by various brand names like Regesterone, Provera and Delvry. The patient needs to take 5 mg tablets twice a day for 5 days. You will get a ‘withdrawal bleeding’ for 2-7 days after the last tablet intake.

Many of the patients visiting Malpani Clinic fear this monthly treatment as they feel they might get addicted to it. It is essential that the patients understand that this treatment is essential and is safe. Just as a diabetic patient needs regular antidiabetic medication to keep sugar levels in control, PCOD patients need hormonal support. These medications are completely safe and have no harmful effects , even if you accidentally take them during pregnancy. This hormonal treatment is supplemented by ovulation induction therapy if the patient plans to have kids.

Summary: PCOD is a chronic disorder of the ovarian system and requires continued medical self management using hormonal support therapy.

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