DEAR READER: Medications can definitely cause feelings of sadness, despair and discouragement. All are feelings commonly associated with depression.

The metformin you were prescribed is commonly used to treat type 2 diabetes or pre-diabetes. It helps control the amount of sugar in the blood and decreases the amount of glucose absorbed from food and the glucose made by the liver. It can also be prescribed to regulate menstrual cycles but does not prevent pregnancy. Common side effects include nausea, vomiting and diarrhea, but not depression.

Your polycystic ovary syndrome (PCOS) can cause erratic or prolonged menstrual cycles, obesity, acne and excessive hair growth. Women with the diagnosis may have difficulties becoming pregnant because of the infrequency of ovulation.

My guess is that you were prescribed birth control to help regulate your cycles, because low-dose birth control with a combination of synthetic estrogen and progesterone can decrease androgen production, correct any abnormal bleeding, and decrease your risk of endometrial cancer. An alternative to this would be to take progesterone for up to 14 days every month, which will reduce your risk of endometrial cancer and regulate your menstrual cycle but will not improve your androgen levels. Treatment for PCOS is geared toward management of obesity, acne, hair growth and infertility.

I don’t know if you have a weight problem as a result of your PCOS, but exercise will go a long way toward lowering your blood-sugar levels. Speak with your physician before beginning any exercise regimen. Request a referral to a gynecologist familiar with PCOS who can direct you in terms of treatment and your depression. Perhaps counseling is in line. A nutritionist can get you on the right track regarding your diet.

It appears you have a lot going on at 20 years of age. You deserve a better outlook, and the help is out there.

To provide related information, I am sending you a copy of my Health Report “Consumer Tips on Medicine.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order made payable to Newsletter and mailed to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.

DEAR READER: PCOS is a hormonal disorder that commonly begins when a female begins menstruation; however, it can develop later in life.

Obesity presents in nearly half of all patients with PCOS and is often the initial complaint. Abnormalities in the menstrual cycle, infertility, pre or type II diabetes and the presence of polycystic ovaries diagnosed through ultrasound are but a few of the other symptoms. It should be noted, however, that having polycystic ovaries is not a firm indication of PCOS.

There is no specific testing for diagnosis. Rather, it is one of exclusion, meaning that a physician will rule out a number of related possibilities prior to deciding on PCOS. The disorder makes other conditions, such as type II diabetes, hypertension and sleep apnea, more likely to occur.

Only you and your granddaughter can determine the sequence of events. When was she diagnosed? Could the PCOS be a result of her obesity? Is that issue under control? I cannot tie in high-cholesterol levels with her excess weight; however, thyroid disorders are often linked with obesity, elevated cholesterol and menstruation abnormalities.

There is help and hope that focuses primarily on her major symptoms. She should exercise and become involved with a regular weight-control program.

Diet modification appears essential. There is some initial evidence of success on a low-carbohydrate diet without discrimination between carbs on either end of the glycemic index. Her caloric intake should be reduced. She should avoid simple carbohydrates such as soda, sugary drinks, doughnuts, cakes and pastries. Any carb intake might focus on choices high in fiber, such as brown rice, whole-grain breads, fortified cereals and beans.

Her physician might decide to place her on low-dose birth control as a means of regulating her menstrual cycles.

She should continue to see her primary-care physician and endocrinologist on a regular basis.

To provide related information, I am sending you a copy of my Health Report “A Strategy for Losing Weight: Introduction to the No Flour, No Sugar Diet.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.