Is it necessary to remove the ovaries?
Q: I am a 32 years old woman with multiple polycystic ovaries and a bulky uterus. The endometrial thickness is 6 mm. I have two children (both caesarean) and sterilisation was done six years back. Now I am having irregular menstrual cycles and becoming obese. My weight is 83 kg now. The doctor advised to remove the ovaries or the uterus so as to prevent other related problems like thyroid, diabetes etc. Will it really help? What is the permanent treatment for this?
A:There is no need for ovary removal or any surgery at all. All you need to do is get on a diet and exercise programme, and metformin treatment, after checking sugars, plasma insulin values and FSH / LH ratio and serum testosterone. The cycles can be made regular by simple weight reduction, with or without medication for weight reduction. If the cycles are still not regular, hormone treatment cyclically after supervision can be started for 3-6 months to a year depending on response- can be combined oral pills or progesterone alone. The risk of future diabetes / endometrial cancer is there only if the disease is left untreated. Treatment for 6 months to a year streamlines the weight as well as cycles effectively. There may be risks of recurrence after stopping medication and therefore follow up is necessary.