Endocrinological Disorders Online Doctors Consultation — page 2

Thank you for your question, this is a very common concern, and you're definitely not alone. Here's a full guideline for managing PCOD (Polycystic Ovarian Disease)— from tests and doctor consultations to treatment and menstrual regulation — structured in a medical + easy-to-follow way. **PCOD (Polycystic Ovarian Disease) Management Guideline** **Patient Name:** [Tehmeena] **Age:** 31 **Chronic Illnesses:** Allergy You need to understand this. **What is PCOD?** PCOD is a condition where ovaries produce immature or partially mature eggs in large numbers, which become cysts over time. It’s linked to hormonal imbalance, insulin resistance, and irregular ovulation. **Common Symptoms:** - Irregular periods or missed cycles - Excess facial or body hair (hirsutism) - Acne, oily skin - Weight gain or difficulty losing weight - Hair thinning or scalp hair loss - Infertility (in some cases) --- **Important Tests to Diagnose and Manage PCOD:** 1. **Hormonal Profile:** - LH, FSH (Day 2 or Day 3 of cycle) - Prolactin - AMH (Anti-Müllerian Hormone) - Testosterone (Total & Free) - TSH (thyroid function) - DHEA-S (androgen level) - Insulin fasting - Fasting blood glucose and HbA1c 2. **Pelvic Ultrasound (TVS or abdominal)** - To check ovarian volume and presence of multiple small follicles (classic "string of pearls" appearance) 3. **Lipid Profile** to assess cholesterol & triglyceride levels **Treatment Goals:** - Regulate menstrual cycle - Reduce insulin resistance - Control weight and hormonal acne/hair growth - Preserve fertility (if planning pregnancy) - Improve metabolic health **How to Regulate Periods:** 1. **Lifestyle Changes (most crucial):** - **Exercise:** 30–45 minutes daily (brisk walking, yoga, strength training) - **Diet:** Low-carb, high-protein, fiber-rich meals. Avoid sugar, junk, processed foods. - **Weight Loss:** Even 5–10% weight loss can restore cycles in many women 2. **Medications (as prescribed):** - **Oral Contraceptive Pills (OCPs):** Regulate cycles and reduce excess hair/acne - **Metformin:** Especially if insulin resistance is present - **Myoinositol + D-Chiro Inositol supplements** – support ovulation and hormonal balance 3. **Cycle Irregularity – Is It Harmful?** - **Yes, if untreated**: It may lead to long-term risks like: - Endometrial hyperplasia (thickened uterine lining) - Fertility problems - Metabolic syndrome - Diabetes and heart disease - **No**, if cycles are medically managed and hormonal balance is restored regularly **PCOD-Friendly Lifestyle Tips:** - Sleep 7–8 hours regularly - Limit screen time before bed - Reduce stress (meditation, journaling, therapy if needed) - Use cycle tracking apps (Clue, Flo) to monitor changes - Avoid skipping meals **Regular Monitoring:** - Blood tests every 6–12 months (as advised) - Ultrasound once or twice a year - Track symptoms like cycle length, acne, hair fall Get the laid consultation. So I can help your in future monitoring. Thank you Dr Shayeque Reza MD 9800280276

Dear Mahesh, I understand your concerns about managing hyperthyroidism and colloid goitre with cystic degeneration. Since you’ve been on Neo-Mercazole 5 mg BD for three years and your doctor has suggested total thyroidectomy, it’s natural to explore alternative options like percutaneous ethanol injection (PEI). General Guidance: 1. Percutaneous Ethanol Injection (PEI) – This is considered for predominantly cystic goitres but is less effective for solid or large goitres. It requires specialized centers and multiple sessions. 2. Total Thyroidectomy – If the goitre is large, causing symptoms, or not responding to medication, surgery is a definitive treatment. However, it will require lifelong thyroid hormone replacement. 3. Radioactive Iodine (RAI) Therapy – Can be an option to manage hyperthyroidism but may not shrink large goitres significantly. 4. Long-term Medication – If you choose to continue Neo-Mercazole, regular monitoring of thyroid function is necessary to avoid complications. Since PEI is a specialized procedure, I recommend consulting an endocrinologist or interventional radiologist to assess if it is suitable in your case. If the goitre is large, growing, or causing difficulty in swallowing or breathing, surgery may be the best option. You should consult an endocrinologist for managing hyperthyroidism and discussing alternatives like PEI. If surgery is considered, an endocrine surgeon would be the right specialist.

Hello amar ji,does other family members have same issues,did u get your diabetes and cortisol test done? As symptoms u have described looks like to me for cortisol deficiency related and u might to get that check,if u have low level the cortisol replacement therapy will help in reducing weight as well as increase in testosterone levels and most of your issues will be resolved