Written By: Dr. Eva Littman, M.D., F.A.C.O.G.
Winter time is great time to encourage your patients to exercise. During the winter months, Gym memberships are at an all time low and great deals are everywhere… Patients especially
those with PCOS should attempt to perform aerobic exercise 3-4 times per week for at least 30 minutes a time. Another healthy tip for PCOS patients is to make sure to keep intake of
Carbohydrates at a minimum. Encourage your patients to read the labels on their food intake and try to keep the average carbohydrate intake per serving less than 20gms. This means
eliminating foods such as rice, bread, pasta, fruits, smoothies, and anything that can be bought at Starbucks besides plain hot tea or coffee from their diet. PCOS patients can also benefit
from incorporating chromium and metformin into their medication regimen. Patients with PCOS have trouble processing excess glucose and as a result are frequently overweight and
metabolically challenged. Metformin helps by decreasing the endogenous production of glucose from the liver and can decrease the total amount of glucose that is processed daily.
Patients starting metformin should only take one 500mg tablet a day and then increase to twice a day after a week. If their fasting insulin is over 10miUI/ML then they can take metformin three times a day. In order to speed up their metabolism, as long as they do not have any contraindications, a daily dose of phentermine 37.5mg is added in with the metformin is very effective. A small proportion of patients with PCOS can achieve monthly ovulations when they lose over 10% of their body weight. Studies show a direct correlation between BMI and fertility. Higher BMIs result in Lower pregnancy rates. Therefore, sometimes, it is useful to place a patient who is overweight with PCOS on a 3-6 month weight loss goal prior to attempting conception.