Q. I have irregular periods with unwanted hair growth and pimples. Please suggest.

Answered by
Dr. Zubayeralam
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Mar 30, 2020 and last reviewed on: Apr 09, 2020

Hello doctor,

I am experiencing irregular periods, sometimes two times a month (latest before three months) and sometimes it will skip for two or three months. I also noticed that I suddenly have hair growing on my stomach and chest. Also, I do not have hair on my legs before but now I have a few hairs growing on some spots. I also noticed that there are suddenly pimples on my back which never happened before, this occurred last month. I have not done any tests on my thyroid or hormones. I used to also take pills (Diane) to regulate my menstruation but after two months I stopped.

#

Hello,

Welcome to icliniq.com.

I can understand your concern. According to your statement, now you are suffering from amenorrhea (absence of menstrual cycle), hirsutism (hair growth in women in the male pattern), acne (pimples-one type of acne on the back) and having no history of thyroid or hormonal test and issues cause you are on childbearing age suggests that it may be PCOS. Polycystic ovarian syndrome (PCOS) can be established by your clinical features with some investigations result.

You should undergo abdominal ultrasound which can detect bilateral polycystic ovaries. You can undergo some blood tests too like blood for testosterone (increased), sex-hormone binding globulin (decreased), LH:FSH ratio (increased) and thyroid test to exclude hormonal diseases.

You can start Metformin (Bigunide-therapeutic class) to restore your regular cycle and fertility and supportive management for your other complications and estrogens therapy.

Hi Doc, thank you for your prompt reply. As we are currently on lockdown, I can't go to the hospitals and get a check-up. However, can I buy this Metformin over the cointer without prescription? So I can start my treatment. Thank you.
# Hello,
how do u do now.have u undergone the investigations?R u on metformin(bigunide) now?
hope u r well.if any complications occur,feel free and inform me.
Hi Doc, I still haven't started on Metformin because I need prescription. Also can't go to a hospital now because of lockdown.
# hello
thnx for knocking me again.
u can take metformin as follow
tab.glucophage(500mg)
1+0+0(after meal) for 7days then
1+1+0(after meal) for 7days then
1+1+1(after meal) for 7 days for 6month.
if u can't tolerate the 3 times daily dose then u can remain on the twice daily dose.

again u can take clomiphene along with metformin for anovulatory infertility in PCOS as given below dose-
tab.clomid(50mg)
1+0+0 for 5days(with or without meal)
if ovulation doesn't occur within 5-10days then 2nd course of 100mg clomifen may be initiated as below
tab.clomid(50mg)
2+0+0 for 5 days.
max. 3 course.
recent studies show that using of both metformin and clomiphene together r more effective than metformin or clomiphene alone.
In case of any problem feel free and please knock me

treatment in a nutshell as below
tab.glucophage(500mg)
1+0+0(after meal) for 7days. then
1+1+0(after meal) for 7days. then
1+1+1(after meal) [to be continued]
PLUS
tab.clomid(50mg)
1+0+0 for 5days (with or without meal).then repeat after 5-10days
2+0+0 for 5days(Max.3 course)
Hi doc, can you please send me this prescription written in paper and signed by you? The pharmacy still don't want to allow me to buy meds. Thank you

A picture of your prescription in paper please
# Hello
Of course.i will send u as soon as possible.can u give me ur facebook messenger or whats up or gmail id?In the meantime,i will also contact with Icliniq team for their suggestion.dont worry.i will send u soon.
Hi doc, this is my whatsapp +63 917 192 9346 and gmail ab.oquindo@gmail.com
What I need is like a e-prescription so I can buy from the pharmacy. Thank you.
# hello
sorry for late reply.i have already contacted with Icliniq.i can't send u a written prescription as i didn't examine physically and it is not internationally accepted.
but u have sent an attachment ealier.it is quite possible.
u should just knock me through my consultation time with ur query.i will reply and u can download that easily.
extremely sorry again.
So maybe just a e-prescription sent through here? So I can show it to the pharmacy
# hi
thnx for knocking me again.e prescription is available in consultation system as far i know.if u seek my consultation then I can send u via Icliniq consultation software system where methods,treatment protocol and reviews on treatment r included.
please come through the Icliniq consultation service.u can also contact with Icliniq support team,they will help u a lot.have a nice day.
Ok then I will take this medicine first and I will report back to you on what will be the effects on me. Thank you.
# Hi
thnx.take tab.phagophage(500mg) for 7days and inform me. tab.phagophage is usually well tolerated to all.dont worry.hope for the best.
Should I take the clomid together with the 1+0+0 Glucophage or with the 1+1+1 Glucophage? Thank you
# thnx.U should take clomid with phagophage 1+0+0. or u can take phagophage only.after watching phagophage' response for 7-14 days u can take clomid then.Recent studies tell that PCOS patients will be beneficial by using both phagophage and clomid together.but my suggestion is just start ur phagophage and watch its action then decide to start clomid.So u have another option(tab.clomid).do u understand?if no then let me know,i will explain u again.
So its Phagophage not Glucophage?
# Sorry
it is glucophage.not phagophage.sorry again for my slip of pen.thnx.
Oh ok thank you so much doc
# U r always welcome.thank u too
Hi doc, should I take the Glucophage at the same time every day? Thank you
# hi there
thnx for the query.u can Glucophage at any time of the day.but it is wise to take after breakfast.so u get time to watch its effects or side effects on u for the whole day.usually it is well tolerated to all as i have mentioned earlier.sorry for the late reply.here internet connection is troublesome.have a nice day.

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