? about lab results not answered above

Angie1981 · 09-15-2005, 10:21 PM

Hey girls,

I'm not really new to PCOS, but since I've been diagnosed, I had my mom have her doctor do some lab work as well (since we have alot of the same symptoms). Anyway, her family doctor did some labs and she started her on progesterone cream. I was really hoping she would be able to get on the Meformin as well, so she has set up an appt. to talk with my doctor. Anyways, my question is she got her actual numbers back today and I was wondering if anyone can look at them and tell me if you feel she has PCOS. I would compare the results to mine, but I was only told I had PCOS, but not given the numbers. The tests she had done were:

Estradiol: 12
Glucose: 99
Progesterone: .3
Testosterone: .18
Insulin: 20.5

I checked the sight on Pat's post, but it says for certain days of your cycle what the numbers should be. My mom's already went through menopause, so I don't know if these would be accurate. Also, these numbers were taken when my mom was fasting.

Thank you in advance for any help!
Angie

omcv · 09-16-2005, 02:06 PM

Testosterone levels may be normal (20-80 ng/dl, 0.7-2.8 nmol/l) or elevated but usually less than 200 ng/dl. Serum androstenedione and dehydroepiandrosterone sulphate (DHEA -S) are usually normal but may be elevated. FSH and LH levels are normal to high normal, often (25%) with a ratio of LH to FSH of 3.0 or more (5). Luteinzing hormone - LH - is usually greater than 9 mu/ml (9 U/L) when ovaries appear polycystic on ultrasound (6).

Adrenogenital syndrome and ovarian androgen secreting tumors can produce this syndrome but the serum testosterone is used to screen for these. If the total serum testosterone is over 150 ng/dl (5 nmol/l) then adrenal or tumor causes should be investigated (7). TSH and prolactin levels are usually normal but are drawn to rule out pituitary or thyroid causes of the clinical symptoms. Measurement of abnormal glucose tolerance often indicates abnormality in the fasting and 2 hour blood sugar, post 75 gm glucose challenge, or the fasting glucose/insulin ratio or hemoglobin A1c.

Ultrasound findings often include multicystic ovaries with the follicle cysts lining up on the periphery of the ovary but it does not always meet the criteria of ten or more follicle cysts in each ovary. Of women who have classic polycystic ovaries on ultrasound scanning, only 50% have the classic hirsutism and anovulation (8). Of women who are felt to have polycystic ovarian syndrome on a clinical and laboratory basis but not on ultrasound criteria, 66-82% have the classic ultrasound appearance expected of polycystic ovaries (9, 10).

Usually the diagnosis includes both anovulation and androgen (testosterone) excess but many related conditions have become lumped together in the literature under the term polycystic ovarian syndrome. Woman with polycystic ovaries on ultrasound do not all have androgen excess, but insulin resistance is manifest in equal frequencies whether or not there are elevated androgens (11). Because of this mixed clinical picture, those conditions all collected under the term polycystic ovarian syndrome in the medical literature may include:

1. traditional PCOS -- anovulatory, increased androgens, no insulin resistance
2. endocrine syndrome X -- anovulatory, increased androgens, insulin resistance or type 2 diabetes
3. non-traditional PCOS --anovulatory, normal androgens, obese, insulin resistant or type 2 diabetes
4. non-traditional PCOS -- ovulatory, increased androgens, mild insulin resistance
5. idiopathic hirsutism -- ovulatory, increased androgens, no insulin resistance

Bunnyscott · 09-16-2005, 10:15 PM

I "believe" that your mom's fasting insulin is elevated, so it appears she may have some degree of insulin resistance. She might therefore benefit from metformin.

I think the E2 (estradiol) level is typical for a post-menopausal woman, as is the progesterone level. I don't know what the reference range is for the testosterone test.

It's good she has an appt with your doctor. You're a good daughter to take care of her!