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Q. Will PCOD cause an increase in weight and absence of ovulation after abortion?

Answered by
Dr. Sugreev Singh
and medically reviewed by Dr. Sushrutha Muralidharan
This is a premium question & answer published on Oct 11, 2021

Hi doctor,

I have been unable to lose weight since abortion. I had an abortion one year ago. I gained 30 to 40 lbs in a short amount of months since discovering I was pregnant last year. I had an incomplete medical abortion at nine weeks three days one year ago. Since that, I have had six months of erratic, very heavy periods, bleeding between periods, clots, etc. I took birth control tablets for four months to regulate my periods. I have been off birth control for six months now. Periods are now back to a somewhat normal state but vary in the amount of days month to month. I have had swelling in my feet and ankles every month since abortion. I had swelling in pregnancy as well before the abortion. The swelling is always a week before my period and around ovulation time, although I never had this pre-abortion. I feel like taking the abortion pills threw me into early menopause because I have always weighed 135 pounds for the last ten years and above. I now weigh 173 which came on me within months. I have had two thyroid tests and cortisol tests which are normal. I have had my female hormones estrogen and progesterone checked that was normal but low testosterone. My hormone doctor put me on bioidentical progesterone, which I do not take anymore because it causes me to swell and did not seem to help with weight gain at all.

I am just at a loss because this is almost what I weighed my last live pregnancy eight years ago. I had the same symptoms when I had a Mirena inserted two years ago that I had removed by my doctor after three months due to extensive weight gain. I went right back to 135 after Mirena was removed within a week. I gained 30 plus pounds within a month with Mirena and, upon removal, lost everything and went right back to 135. The Mirena made me swell just like I am doing now, but I am currently on no birth control or hormones because of intolerance. I am 39 years old, weighing 173 pounds. Kindly help me.

#

Hi,

Welcome to icliniq.com.

Thank you for writing, and I understand your concern. Mam hormonal changes and PCOD (polycystic ovarian disease) can lead to such unwanted weight gain. Most probably, it is associated with PCOD. Because PCOD is a common one and you have a history of the irregular menstrual cycle. So that is why I suspect that.

Usually, a physical workout will help in this case because it regulates the hormones and cures PCOD, so start exercising such as jogging and running.

Mam, you should do USG (ultrasonography) examination once to check what is going on. It will help to diagnose PCOD and other pathologies as well. So please do the USG examination and send me reports.

Can you please send me your thyroid reports? Do you exercise daily? Did you notice that your weight is mainly increasing in the abdomen area or whole body?

Please answer the questions for better help.

Hi doctor,

Thank you.

I have been to my regular gynecology doctor, who performed an ultrasound, and I also gave her some of the blood clots I was passing to send off to pathology. The pathology report came back normal. The ultrasound she performed was abdominal, and she said my ovaries and endometrial lining, and thickness all looked good. No cysts are present. Prior to all this, I never had irregular menstrual cycles. I have always menstruated every month, every 28 days at least. It was only after the abortion that everything got all whacked out. I did the medical abortion, but it failed. I was nine weeks and three days. I went back to the abortion clinic, and the doctor did a vaginal ultrasound which he saw some leftover products of conception, so he then gave me around 16 more pills to start that Monday at noon, taking two every four hours till complete. I never had any more bleeding till a week later, and that is when I went to my doctor to have her do another ultrasound to make sure I did not have any remaining products left inside. From then on, my periods have been so crazy. First six months, I had very, very heavy bleeding and cramping. Then after that, my periods went back to normal consistency, no clotting but shorter duration sometimes. And no, I never exercise. I have never really had to and always have been thin, just eating what I want but with portion control. I cannot even lose 1 pound now. It is making me crazy because I hardly eat anything at all. I have also purchased multiple ovulation tests, and I am pretty sure I am not ovulating, considering I am doing a test every other day for the entire month. My swelling in my ankles and feet usually happens the week before my period and again around what would be my normal ovulation time (although I am not ovulating). My thyroid tests results are as follows:

The first test performed when I realized I was pregnant last year was as follows:

1) TSH - 1.12.

2) T3 - 4.13.

3) FT4 - 1.56.

My next tests were seventeen months ago is as follows:

1) TSH - 1.30.

2) T4 - 1.14.

3) Testosterone - 7.

4) Free Testosterone - 0.7.

5) LH - 4.1.

6) FSH - 3.1.

7) Progesterone - 4.3.

8) Estradiol - 70.2.

This test was performed by a gynecologist or hormone doctor. And it was performed on day 21 of my cycle. Kindly help me.

#

Hi,

Welcome back to icliniq.com.

Everything looks normal in the reports, along with diet. You should start exercising because your reports and USG as you mentioned, looks absolutely fine, so maybe the effect was due to pills, but now reports are normal, so no hormone replacement therapy is required. It is just diet and exercise that will help you.

Another thing is it is not age for menopause. Menopause usually starts after 45 to 51 age. Some females experience weight gaining symptoms after taking contraception. And you have a history of it. Now regular exercises at least for 30 minutes followed by healthy diet such as less oily and low caloric diet will definitely help to reduce weight.

Take more fluids, juices and lemon, water, etc. Keep yourself hydrated. And do not worry because if anything abnormal, then it would have should up in the tests.

Do you have a history of thyroid disease in the family? If anything else, please let me know.

Hi doctor,

Thank you.

So do you think it could possibly be PCOS? I am holding most of my weight in my stomach area. Also, what is causing me to have low testosterone and no ovulation? I feel like possibly my ovaries are not functioning correctly. Kindly give your opinion.

#

Hi,

Welcome back to icliniq.com.

Yes, I suspected PCOD (polycystic ovarian disease) only, but then you said that your ultrasound reports were absolutely fine. So maybe you can repeat ultrasound reports once again and see if they find PCOD or any other growth. When was your last ultrasound report taken? Can you please send me reports if you have them with you? I will go through it and let you know.

Hi doctor,

Thank you.

I will try to contact my doctor tomorrow to see If she has them and will send them to you. My last ultrasound was taken one year ago. I used to tell when I was ovulating based on timing in the cycle, cervical mucus, and a cramp either on my right or left side each month (it would alternate sides). I do not get that same pain anymore, and I have taken multiple ovulation predictor tests to only get negative results month after month. I take a test about every other day and have not ovulated. I am still getting no LH surge. I feel like my ovaries may not be working as they should be because of this and the fact that sex is more painful because of dryness that I have never had before till now.

My PMS is horrible. It is more like PMDD. I get enraged at everything it seems and cry for no reason. I have never had PMS like this before. Not to mention all the swelling in my ankles and feet. I never had swelling like this, even when I was pregnant. I am very irritable all the time, depressed because of self-esteem issues about my weight, etc. The only time I felt like this was when I had the IUD Mirena three years ago. I had to have it removed because I gained like 30 to 40 pounds in 1 month. My doctor could not believe it, but I had these exact symptoms with it. I had it removed after begging my doctor because she did not think the IUD was causing my problems, but I was convinced it was. So, upon removal, I lost every single ounce of weight, went right back down to 135 after being at 173. My doctor was speechless. I never changed one thing about my eating or exercise habits, and the weight fell off after removal. I feel exactly like this now but not on any birth control or hormones and have not been in 6 months. Not to mention I am getting terrible acne now and the same when IUD was inserted. It is like my body thinks it is pregnant or something. I am not sure, but it is making me so miserable because I cannot find the answer to it. I have been going through this for over a year now. I have tried diets, weight loss clinics with HCG shots, probiotics, vitamins, colon cleansing, etc., nothing helped. I need some answers because I am exhausted thinking about it, and it is taking a toll on my mental and physical health. Does any of this sound like diabetes possibly? I am just grasping at straws at this point because I have done everything I know to do. Kindly give your opinion.

#

Hi,

Welcome back to icliniq.com.

Actually, you should repeat the USG examination that will only clear doubts as I suspected PCOD and your last USG examination was one year ago. In this short time, there can be many changes in your ovaries or uterus. No ovulating ovaries have more chances of PCOD. And all other symptoms such as acne, painful intercourse, weight gain are seen in PCOD. So definitely, you should do the USG examination once again. And then we can treat accordingly.

From my point of view, in the USG examination, something will show up, whether it is PCOD or some changes in the uterus or other organs as well.

Along with that, you can do LFT (liver function test), KFT (kidney function test), HbA1c (hemoglobin A1c) to check out if you have normal functioning kidney and liver. HbA1c will help to rule out diabetes.

But in diabetes patient experiences symptoms such as thirsty all the time, frequent urination, increased appetite, etc. I do not think you have diabetes. But it is a routine test. You can do HbA1c.

After all, these investigations and treatments can be given accordingly. Till that, please do not bother yourself because other reports are absolutely fine. So nothing to worry and PCOD can be treated. For acne, I suggest you apply ointment Adapalene 0.1% before sleeping for seven days. And use lubricants during intercourse to avoid pain-like symptoms.

If anything, I am always here to help you. I hope this was helpful.


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