How to control acute pain, which only reduces after taking morphine in a PCOS/PMOS patient?

Question

Hello doctor,

I have a history of multiple follicles (20 each) on both ovaries. I have not taken any medications for that yet. I have severe pain at times that goes off only when taking Morphine. I have taken blood tests and an ultrasound.

Answer 1

Hello,

Welcome to icliniq.com.

Your ultrasound (attachment removed to protect patient's identity) suggests a polycystic appearance of the ovaries, but having polycystic ovaries and a polycystic ovarian syndrome called PCOS (polycystic ovary syndrome)/PMOS (polyendocrine metabolic ovarian syndrome) is entirely different. It depends on your symptoms. Do you have any menstrual problems like irregular or delayed cycles, or do you have features like excessive hair growth or acne? If any of these is present, we need to give you medicine to treat it; otherwise, nothing has to be done. Additionally, regular exercise and a healthy diet are essential for improving this condition. Is the pain you are talking about only during the periods or other than that? Kindly answer these questions so that I can help you out.

Answer 2

Hello,

Welcome back to icliniq.com.

All these symptoms and ultrasound report points toward a diagnosis of PCOS/PMOS. Therefore, you will need to take oral pills daily for 3 to 6 months. But before that, as you have not had your periods, I suggest you consult a specialist and take the following medications with their consent. First, tablet Meprate (Medroxyprogesterone acetate) 10 mg twice daily for five days, and when you stop this medicine, you will get your periods within 3 to 5 days. Then from day 1 or 2 of your periods, start taking Dronis 20 mg (Drospirenone and Ethinylestradiol) one tablet daily at night for 21 days continuously, then stop for seven days when you will get your next periods, then again start for 21 days. Continue this cycle for three months. This will help in regularising your cycle and your weight loss, acne, and pain. Meanwhile, repeat your serum prolactin level, and if it comes raised on a repeat sample, then medicine for this will also be required. Secondly, get your fasting and postprandial blood sugar and lipid profile done. All these things should be followed along with regular physical activity and a healthy diet, including more fruits and salad, less sugar and oily fried food.