PCOS question

[manifestdstny.livejournal.com]

Backround:  I've been suspicious that I have PCOS for a few years.  I have almost every symtom (irregular period, eating healthily but still having trouble maintaining a healthy weight, acne, dark skin patches on my thighs, excess hair on my lip/stomach/toes). I also haven't gotten pregnant after about 8 months of not using protection.  I brought this up to my doctor a few years ago, and was tested for thyroid/ insulin level promblems. Both tests came back negative, so my doctor dismissed my concern.  I went back a few years later, and was told the same thing. I was never even given any possibility as to what is wrong with me.   It's soo frustrating.

Questions:  What other tests could be done to diagnose PCOS?  My insurance is wacky and doesn't cover much, so is it possible to be checked at a PP?  What else could these symptoms mean? 

Comments

[speckled-hen.livejournal.com]

They can only diagnose it with an ultrasound (sonogram) as they need to see the folicles on the ovaries to confirm it as a diagnosis.

[manifestdstny.livejournal.com]

Really? I was told that a thyroid/insulin test would determine it by my doctor.

[geminigirl]

It's so much more than thyroid and insulin. Have your hormone levels been checked? Things like testosteron, LH, FSH, estrogen and prolactin should all be screened. The ultrasound helps, but cysts aren't required for a PCOS diagnosis.

[speckled-hen.livejournal.com]

It could be because of where we live? I'm in the UK, if that helps!

[redshira.livejournal.com]

Not all cases of PCOS involve cysts on the ovaries, though. Unfortunately, a lot of doctors don't seem to know this, or care.

[geminigirl]

Have you had an ultrasound to check the condition of your ovaries? While cysts aren't a requirement, they're a common symptom. PCOS, however, can be diagnosed based on symptoms even when cysts aren't present. Are you having ovulatory cycles-determined by either charting or using OPKs? Pregnancy is much harder for most people to achieve than we're led to believe, and if sex isn't timed just right, it's impossible to get pregnant. Most doctors won't consider an infertility issue until you've been trying for a year (if you're under 35) and have no diagnosed health problem that could impair fertility issues.

A borderline thyroid number can make a big difference, and not everyone is using the most current information about when to treat thyroid concerns. Can you get a referral to an endocrinologist or reproductive endocrinologist for further testing and follow up? That might be the best way to get a solid diagnosis.

[http://users.livejournal.com/_cant_explain_/]

I'll definatly look into getting a second opinion.

[redshira.livejournal.com]

It's not at all uncommon for bloodwork to come back "normal" in PCOS because the lab values are so broad. Mine always does, so I've had years of being told there's nothing actually wrong with me despite the body doing all kinds of crazy stuff. Unfortunately, it's not at all common to find a doctor who will look at the person rather than the paperwork. As has already been mentioned, an ultrasound to see if you have cysts on your ovaries will be very useful. If you don't, then that's going to make things a lot less easy for you, I'm afraid. I agree with the above poster who suggested a referral to a reproductive endocrinologist. You ought to have had a full hormone profile done anyway, just insulin and thyroid won't necessarily show anything. Was your insulin test a three-hour glucose tolerance test with multiple blood draws?

[kelism.livejournal.com]

What would the thyroid and insulin look like if they were off?

[redshira.livejournal.com]

I don't know what system they use for measuring over there (I'm in the UK), but here (http://www.soulcysters.net/guide-understanding-lab-results-pcos-63885/) is a really good set of links explaining how to interpret results, and why the lab values are so broad and often report that everything is normal when the symptoms are all making it very clear that it is not.

[geminigirl]

My bloodwork too, comes in within normal ranges...all of it...thyroid, insulin, and hormones. And yet, I've got both a hypothyroid diagnosis and a PCOS diagnosis based on other symptoms. And I feel so much better now that I'm being appropriately treated for both. Metformin and Synthroid have made me feel so much better.

[redshira.livejournal.com]

I'm glad you were able to get diagnosed; so many women are dismissed because their doctors believe the paperwork instead of the women who, after all, live in their bodies and know best what is normal for them and what is not. I'm on Metformin too, it's literally been a lifesaver for me.

[majellen.livejournal.com]

You can have PCOS without having insulin resistance. I'm living proof of that...I have more cysts on my ovaries than a tiger has stripes.

If you're trying to get pregnant, see if you can get an appointment with a reproductive endocrinologist. They specialize in fertility issues and might be a little more willing to look deeper into your period being erratic.

When you say irregular, how irregular is it?

[manifestdstny.livejournal.com]

Well, up until a year ago I would get it once every 4 or 5 months. Since June of last year, I've been getting it almost every month/every other month. Right now my cycle length usually varies from about 25 to 45 days.

[majellen.livejournal.com]

That alone should get your doctor looking at the issue more closely - the 4-5 months part. The 25-45 day cycle part maybe not as much.

Still, I'd get a second opinion if I were you.

[calico-drive.livejournal.com]

My ultimate diagnosis was basically "symptomatic of PCOS" but not precisely confirmable as such as only a few of the tests showed anything more than borderline results.

The three (bulk-billing/free) Drs I saw at first basically told me I was paranoid and there was nothing wrong. It wasn't until I paid a bunch of $ to go see an expensive and uber-qualified gyno that I actually got anywhere.

[smiley-laydee.livejournal.com]

Mine was found through an ultrasound scan too