Q: I am a 27 years old woman in the 4th month of pregnancy. The doctor has advised me to continue with Susten 300 mg, Thyronum 50 mg and Hyponidd as I have polycystic ovary syndrome (PCOS). Is it safe to use Susten vaginally during pregnancy?

A:Hyponidd is an ayurvedic product. As per Supreme Court orders, allopathic doctors are prohibited from prescribing ayurvedic/unani and other alternative medicines about, which they know very little. Such doctors are liable to be fined and punished (including a jail term) as if they are quacks, if a complaint is lodged with consumer court. Action can also be taken by the Medical Council of India to suspend/cancel their registration to practice medicine. There is no documented evidence about the safety and efficacy of Hypnoidd particularly in pregnancy. If you are suffering from diabetes, please make sure that it is kept under control through appropriate medication and diet control. Thyronorm is certainly required if you are suffering from hypothyroidism. Oral Susten (progesterone) is not permitted (contraindicated) during pregnancy since it can cause congenital anomalies including cleft palate, ventricular septal defect, patent ductus arteriosus and other congenital heart defects. Some cases of foetal death and spontaneous abortion have also been reported in pregnant women prescribed oral progesterone. Even Susten, through vaginal route, is approved in western countries for progesterone supplementation or replacement as part of an assisted reproductive technology treatment for infertile women with progesterone deficiency. In other words progesterone in its topical form (vaginal route) is to be used only in cases of female infertility when there is proven, documented deficiency of this hormone. In your communication there is no mention of any deficiency of progesterone. There are many causes of sub-fertility in PCOS. In any case, once a woman has conceived there is no clinical need to use progesterone.