How to manage PCOD presenting with obesity, irregular periods, fatty liver and depression?

Q. I have PCOD with depression and fatty liver. How to manage it?

Answered by
Dr. Muhammad Zohaib Siddiq
and medically reviewed by Dr. K Shobana
This is a premium question & answer published on Mar 08, 2021 and last reviewed on: Jul 06, 2023

Hi doctor,

I am 32 years old with a weight of 249 pounds and a height of five feet eight inches. I have insulin resistance problem for 15 years. I have acanthosis nigricans with PCOD and my periods are irregular. I suffered from jaundice at the age of 10 and it has damaged my liver causing fatty liver. I had a premature birth. I always try to lose weight and I cannot stick to anything for a longer period of time. I get bored quickly and I have migraines with a sleeping disorder. My back of the neck hurts me a lot. I cannot sleep with the low pillow. Before a year, I had a heavy nose bleeding from the right side of the nose. I lost my blood and my hemoglobin got reduced from 11.2 mg/dL to 9.6 mg/dL. I had some blood clots and when I try to move my face up, blood gets into the throat and I will try to pull it out. It took 40 minutes to stop my bleeding and my blood pressure was 140/105 mm Hg. For the past couple of months, I have palpitation problems. My pulse got raised upto 135 beats per minute. Normally, I have a pulse rate of 88 to 97 beats per minute. Sometimes, I have pressure on my jaw, neck, and left hand. Sometimes, I have stretching of veins below the breast on both sides. Sometimes, my left ear becomes numb and the surrounding area of the ear becomes numb and I feel the pressure below the left side of the neck. I feel some sensation on my upper left back near the shoulder blade. It seems to be a crawling sensation under the skin. Sometimes I feel this below the back and it is present mostly at the time of the shower. I have pain on the upper left side of the tummy. It lasts for a minute to hours. But it starts intensely and it becomes mild later after taking rest. I feel to have stretching in my left-hand vein and it causes a lot of distress. Sometimes, I feel it in my heart. I was diagnosed with IBS and took treatment for two months. But still, I burp a lot. Sometimes even after eating food for six hours, I can still taste the food in the burp. Sometimes I have pain in my heel and I cannot able to walk. I am unable to place my foot on the ground due to pain and walking causes more pain in my heel. I was diagnosed with prediabetes. Now I am under depression due to my overall health. I am dealing with obesity throughout my life. Now my body is fat and saggy. I am unable to control my body and I do not have beautiful skin with too much facial hair present on my chin. I have consulted many doctors but I am not getting well. I want to live my life happily with a stronger mind. My depression is killing me a lot and I do not want to take anti-depressants as they cause weight gain. Please suggest.



Welcome to

Most of your problems are due to PCOS (polycystic ovarian syndrome) and its complications are obesity, diabetes, facial hair, hypertension, and depression. You need to manage depression first and do a thyroid profile soon. You need to consult a gynecologist soon to manage PCOS. Though there is no cure, it can be managed by taking medicines and doing lifestyle changes. Pray five times a day. Do moderate exercise, eat a Mediterranean diet, and have intermittent fasting. Once when you start doing exercise, you will start to lose weight. It will correct your diabetes and menstruation problems. You may require to take antidepressants and it depends on you that how you manage your depression.

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