Discussing the case of patient X who presented to the OPD ,2 years back . She was a 19 year old girl who came to us through a reference .Patients mother had shown her daughter to their family GP for weight loss and was put on some health supplements , almost unheard of ( v had to literally Google to see the pharmacological composition of her prescription).She was also referred to a senior and respected Gynecologist , who correctly diagnosed her with PCOS & who put her on low dose OCP to regularise her periods and reduce the hirsutism and acne.
After 1 cycle only , mother wasn't happy with the prospect of her daughter being put on hormones, so decided to switch to herbal remedies for the next 6 months with some lifestyle ammends.
Meanwhile her 19 year daughter studying in Australia ,got caught amidst the pandemic last year when delta was at the peak. They called us in the first lockdown , asking for an online consultation .
After receiving all the reports on watsup , we insisted on seeing patient in person .
Mother was paranoid, we insisted on examining patient ourself. Finally, on ultrasound done in the clinic , there were 15-18 follicles arranged peripherally, with characteristic PCOD pattern and increased ovarian stromal density bilaterally.
On examining, she was 46 kg girl with hirsutism , Ferriman- Galleway score 6 with acne and thin scalp hair.
They started complaining to us, none of the doctors or treatments are working and our Gynecologist put her on steroids/hormones!
First thing we said to them was , your Gynecologist is right . "Combined oral contraceptive drugs are the first drug of choice for PCOS."
Second thing we said was PCOS is a syndromic disease that needs patience , symptoms can be controlled and resolution of symptoms takes time . Most treatments take time to work like 2-3 cycles.
Studies show that androgenic symptoms of PCOS like alopecia, hirsutism and acne all respond very well to oral contraceptive pills ( OCPs) and so only have been recommended first line treatment in teenage adolescents. OCP treatment is recommended by ESHRE , RCOG and all international guidelines ! So plz trust your Gynecologist ...
The hormones which we prescribe are safer than the roadside golgapas or panipuris. They have already gone through approvals specific for younger girls. The idea of starting low dose OCP's is to fool your body into believing it is producing the hormones estrogen and progesterone in a biological proportion. The side effects of chronic anovulation ( if patient of PCOS is left untreated), are much more grievous , than not taking appropriate treatment.
We shall continue to share our experiences in order to enlighten our younger followers about PCOS . For more information , stay tuned with us...