Infertility/Fertility/Uterine issues

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Question
Hi I am writing from India. I am a 32 year old female, 5'7" ht currently at 67 kg odd. All my twenties i was at 56kg or so and looked quite thin. In my teens, at the same height i waa 45kg. The 11kg i put on was a deliberate attempt to not be underweight. I experienced anaemia through most of my twenties despite taking supplements . Somewhere down the line at 27 or so I started developing a bit of IBS. I was also staying on campus at the time and wasn't getting adequate nutrition possibly as I wasn't taking care of myself. Later i got married and moved to a new house where all meals revolved around meat products that were processed. I started developing mild hirsuitism, painful periods, pelvic pain, painful ovulation and when i got blood tested, slightly high testosterone levels. I also started putting on weight, and getting food cravings. Bloating and inflammation was regular as I was eating outside food regularly as well. I changed my diet after, in the past one year to include vooked vegetables and less processed food.

Recently i felt an obstruction in my urethra while urinating and pelvic pain as well as excessive ammonia smelling discharge. Through all this though, my periods are always regular and never been a cause for concern. I visited a gynaec recently and did a transvaginal ultrasound in which she discovered a cyst on my left ovary and a 3 times thickened endometrium. She has prescribed me progesterone twice a day for 5 days and contraceptives post that. The diagnosis for pcos was given before the ultrasound. Id like to know if you can tell me what I could do beyond her medicines to get better: diet, exercise etc and if I am at risk for cancer. Thanks very much in advance.

Answer
Hello MM from India,

The regimen your doctor put you on is appropriate for treating the thickened endometrial lining and the ovarian cyst.  No other studies have been done to confirm or find the diagnosis.  As such, I cannot give advice on what would be the best treatment.  I would advise you to see out a competent endocrinologist or reproductive endocrinologist for further evaluation.  Once a thorough evaluation has been done, which shoud yield a diagnosis, then an appropriate treatment regimen can be given.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
info@montereybayivf.com

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate.  I also now provide an Email Concierge Advisory Service with a 1 year subscription for patients that want easy access to me to answer questions along their journey (women's health, infertility, pregnancy).  Contact me at ejrmd@montereybayivf.com if you are interested in continuous access to me.  

Infertility/Fertility

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Edward Joseph Ramirez, MD, FACOG

Expertise

I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.

Experience

I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 19 years.

Organizations
American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, Society of Assisted Reproductive Technology, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists,Resolve-National Chapter, Open Path - Northern California, Board of Directors Monterey Medical Society

Publications
American Journal of Obstetrics and Gynecology, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

Education/Credentials
Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco

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