Successful tactics for managing a patient with obesity and menstrual irregularities

The purpose of this study was to substantiate the possibility of successful management tactics for a patient diagnosed with grade 1 obesity (BMI, body mass index 33 kg/m²). Impaired glucose tolerance. Dyslipidemia. Polycystic ovary syndrome. The patient complained of irregular menstruation, with delays of 30-60-90 days, and progressive weight gain. The patient was prescribed treatment. Daily aerobic physical and moderate strength training, nutrition with a calorie content of 1400 kcal per day. In order to regulate the menstrual cycle and prevent endometrial hyperplastic processes, the patient was prescribed didrogesterone 10 mg 2 times a day from the 14th to the 25th day of the cycle. In order to correct body weight, a drug was prescribed, which is a combination of sibutramine + microcrystalline cellulose. The patient also received metformin at a dosage of 1000 mg. The treatment was carried out for 6 months. The dynamics of the indicators was studied after 3 and 6 months of therapy and was as follows. The patient’s menstrual cycle returned to normal, after 3 months the weight decreased to 77 kg, after 6 months to 65 kg. The body mass index after 3 months was 30 kg/m², after 6 months it was 25 kg/m² (normal). Waist circumference was 85 cm after 3 months, 75 cm after 6 months. In addition, normalization of lipid and carbohydrate metabolism was noted. An integrated approach to therapy, with the inclusion of didrogesterone and a drug in the treatment regimen, which is a combination of sibutramine + microcrystalline cellulose, as well as metformin, made it possible to achieve body weight correction, normalization of metabolic parameters and also contributed to the normalization of the menstrual cycle, ovarian and endometrial conditions, which is especially important in a patient, in particular subsequently planning a pregnancy. The choice of these components of complex therapy was determined by the peculiarities of their pharmacodynamics, as well as the peculiarities of the effect on the body of an obese patient, consisting in a positive effect on various structures and functions of the body, while not exacerbating existing metabolic disorders. This clinical case illustrates the need for an integrated approach to the treatment of patients with obesity and menstrual disorders, the positive experience of such treatment can be used to manage other patients in similar clinical situations.

obesity, menstrual irregularities, insulin resistance, dyslipidemia

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