Letrozole? NHS BMI of 42
I was diagnosed with PCOS a couple of years ago now. My BMI is 42.9 and my periods are really irregular/absent. I have been trying to eat healthy and exercise when I can however, I have a previous (mostly recovered) binge eating disorder, coeliac disease, and chronic migraines (new meds are helping) – all of which can make this difficult but I am doing my best. I have previously been on GLP1s, privately paid as the NHS doesn’t see PCOS/PMOS as a good enough reason to prescribe them (ridiculous but don’t get me started) however these made my migraines worse and therefore had to stop. I am on metformin, inositol, folic acid for my PCOS. Propranolol for migraines. Also recently started taking magnesium and also zinc and am looking at taking B6 and L-carnitine. I have B12 injections due to coeliac also. I was referred to weight management services in September 2024 and still haven’t been seen – I have chased this and been told they are really busy and will get to me when they can.
I am TTC and am tracking my BBT. I am not using LH strips as have seen these are inaccurate for people with PCOS. It has been 102 days since my last period now however I have had spotting for about a month, not sure if this would class as a period but I doubt it. I have an ultrasound just after my last period in February which showed multiple cysts (immature follicles) on each ovary too.
I wanted to wait until I lost weight until TTC however this is proving very difficult due to the above and I don’t want to waste more time. I know I am only 24 however it frustrates me when people say “you have loads of time”, it is irrelevant of my age as to when I should have children. I have been with my fiancé for 7 years and we feel more ready than ever. I have wanted to be a mum for so long and don’t want to wait any longer.
I have been looking at letrozole/clomid as I have a GP appointment on Monday however from what I can see I would have to be referred to gynaecology for this and would need a BMI under 35. This is terrifying to me as I would need to lose around 4 stone and I am struggling to even lose 2 pounds. Once I’ve lost the weight the waiting lists are ridiculous in my area, at around 64 weeks for an initial appointment. I’ve seen mixed information online as to whether I would be able to get letrozole currently, some say no but others say as I have PCOS and most likely anovulatory infertility, that I would be able to?
Please let me know your experiences/advice/knowledge.