Is it necessary to get polycystic ovarian disease (PCOD) treated?

Q: I am a 30 years old woman who has been diagnosed with PCOD. I am also relatively overweight, don’t have insulin resistance and have irregular periods (once in three months). The irregular periods started after my first delivery. The doctors suggested two different medications – Metformin 10mg and Yasmin. I came to know that Metformin helps to ovulate and Yasmin prevents ovulation. I am confused that if they do opposite things then what would be the effect when they are taken together? Do Yasmin and Yaz help the same way with PCOD? I am also worried about taking birth control pills. Will it cause any side effects while trying for a baby any time later? Is it fine to leave PCOD untreated and focus on diet and exercise alone and to see if it will help?

A:PCOS always needs to be treated to prevent long term harmful effects like diabetes, high blood pressure, endometrial hyperplasia or cancer. OCPs are a good choice if there are irregular cycles as well as increased hair growth. In cases where obesity is the main problem, with irregular menses, then weight reduction with diet and exercise does cure many cases, but may take more time. Taking Metformin, in addition to diet and exercise helps regulate the cycles faster, induce ovulation and also enhance weight loss. It may be associated with a few side effects like headache and nausea- in some cases.For pregnancy, after the cycles is regular- egg forming drugs like Letroz or Clomiphene are available - which can be taken.