Dr. Sameer Kumar
Obstetrics and Gynecology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I have been having PCOD since last 14 years. I started treatment before four years with Bigomet SR 1000. After continuing it for eight months, I had periods with more gap compared to earlier. Then, I had periods only with the help of medicine and so, I left the treatment. I started my treatment again before nine months and had regular periods. I dropped the treatment again. I have to regularize my periods now using medicines as I am planning for pregnancy. I am taking Myotol-F and Folvite for the last one month. During this period my doctor gave me three tablets and said after 10 days my periods will occur. Now, it is more than 10 days and no periods yet. I have attached my laboratory test reports for your reference. Is there any other problem?
Hello,
Welcome to icliniq.com.
I have gone through the reports (attachment removed to protect patient identity) and in your case, PCOD (polycystic ovarian disease) is not a problem for delayed menses, but high prolactin levels due to hyperprolactinemia. PCOD can be controlled with diet, exercise and weight loss and even with Cyproterone oral contraceptive pills, but menses would not regularize and ovulation would also be irregular if the prolactin levels are not under control at all. I suggest you dopamine agonists like Cabergoline, twice a week for three to four weeks to bring down the prolactin levels.
Presently, I believe you have been given progesterone pills for initiating withdrawal bleed, but just mere 3 pills of even Primolut-N are insufficient to initiate a bleed. Hence, you have not received a withdrawal at all. Wait for another five days and if menses do not occur, then you should be started on Primolut-N 5 mg twice a day for five days at least and then withdrawal should be expected in the next 5 to 7 days from the day of the last pill intake. Consult your specialist doctor, discuss with him or her and get the dose altered.
Patient's Query
Thank you doctor,
Should I take Cabergoline along with Myotol-F and Folvite?
Hello,
Welcome back to icliniq.com.
Yes, Cabergoline should be started along with the other two tablets and it has to be prescribed by your gynecologist.
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Obstetrics and Gynecology
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