Why PCO patients should induce a period every month

Polycystic ovarian disease ( PCOD) is a common cause of infertility. Typically, most of these patients have irregular cycles because they don't ovulate regularly. Now, because they don't ovulate, they don't get pregnant , and they don't get regular periods either . This is because they produce a lot of estrogen, but there's no progesterone production at all, because of the lack of ovulation.

Now, this means that every time they miss a period, they're very hopeful that this time they could be pregnant. They wait and they wait, and after two months or three months they don't get a period, they finally go to a doctor who does a pregnancy test and then induces a period for them with tablets which contain progesterone. This happens once; then it happens twice ; and when it happens again and again , they start getting fed up and frustrated.

A lot of them are very scared of all these hormonal tablets which their doctor uses to induce a period , because they have been told that artificial hormones are dangerous ! They are worried that they will cause cancer; or will have side effects ; or that they'll get dependent on these tablets , which means their body will never start working properly. As it is they have low self-esteem, and this just makes it worse.  A lot of them believe that if these tablets are powerful enough to induce a period, then if they accidentally take the tablet when they are pregnant , they will end up miscarrying and losing the pregnancy.

This is why they waste a lot of time waiting to get a period. Not only does this false hope just add to their stress, it is also the cause of a lot of wasted opportunities. Until they induce their next period, they're not going to be able to ovulate,  and therefore won't be able to get pregnant. This means that if in an entire year, if they only get a period four or five times, their chances of getting pregnant on their own goes down dramatically.

This is why PCO patients must induce a period once a month , so that they have a better chance of getting pregnant Once they've induced a period, they can then try to induce ovulation in the next cycle. The tablets which  are used to induce a withdrawal bleed contain a hormone with the unpronounceable name , medroxyprogesterone acetate ( MPA for short).

The good news is that these tablets are  extremely safe. These are natural hormones, the same hormones their body would normally have produced if they'd ovulated on their own . Because it's a natural hormone, it has no long-term side effects . Of course, the tablets only act in the month in which they take them . This often confuses them, because they feel that they have become "dependent" on the tablets.  The truth is that the underlying disease remains - after all, the progesterone doesn't treat or cure the PCOD - it  just induces a period , and that is it's only role.

The beauty about progesterone is that it's very safe during pregnancy. This means that even if they take it inadvertently when they're pregnant, there is absolutely no risk to the baby. 

Taking progesterone to induce a monthly period is something which PCO patients need to learn to do for themselves - and a good doctor will teach them how to do this, so they don't have to go running to the doctor every month every time they miss a period. Patients need to learn more about their chronic disease , so they're empowered enough to be able to manage it for themselves. There are a lot of simple things that they can do for themselves, so they don't have to seek medical attention unnecessarily , or waste a lot of time in their quest to have a baby.

Even if PCO patients don't want a baby,  they should still induce a period every month. Otherwise, the continuous unopposed estrogen exposure will cause their uterine lining to build up, and endometrial hyperplasia can be a premalignant condition if not treated properly.

You can read more about how we treat PCOD at
http://www.drmalpani.com/knowledge-center/the-infertile-woman/how-to-manage-your-pcod