I've been reading all of your posts, and I've realized that you've all had blood work and usually ultrasounds. I've never had bloodwork or an ultrasound. I was diagnosed in February of 2008 at age 30 after having symptoms since I was a teenager. As a matter of fact I remember actually having bloodwork done when I was 19 and my doctor telling me that I was producing too much testosterone because I had gained too much weight.
Anyway, I have all the classic symptoms with the exception that I do have mostly regular cycles with the exception that my periods only last 1 day. I've been on metformin since diagnosis and I actually had "real" periods for a few months (4-5 days complete with cramps and pms) which makes me believe that I really wasn't ovulating all these years.
Should I request blood work? Should I get a new doctor? I love my doctor, but he's a Gyn. I lose 40 pounds initially and I've kept it off, but I've been unable to lose more...I feel like the metformin isn't working anymore. All my symptoms are back bad.
Depends on what you want to accomplish. If you're trying to lose weight, it might be really good to get some bloodwork done to make sure your thyroid is functioning right and just get more information.
I was diagnosed via blood tests and an ultrasound when I hadn't had periods for more than 6 months. But I didn't need any treatment until DH and I wanted to start TTC. If you don't have any complaints, it's possible that you don't need any treatment.
What you need for tests will depend on what you want to achieve with treatment.
Someone who wants to have children would be given different treatment for different reasons than someone who doesn't. I suspect that most doctors will only treat a symptom if you consider it a problem.
The one symptom that made me start looking for treatment was hypoglycaemia. I was having daily episodes of low blood sugar that I couldn't control with dietary changes. PCOS and the path towards type II diabetes are similar biological processes and the main treatment for both is Metformin. Spironolatone was added because I also had symptoms of PCOS -- excess weight, irregular periods, unwanted facial hair and thinning hair on my head, etc... you all know the list.
As a DES daughter, I refused birth control pills because for me they could increase my risk of cervical cancer. I had to explain this to my GP and my Endocrinologist, they don't know about DES because it wasn't used in the UK. Also as a DES daughter I'd made the decision not to have children so I don't take any medication specifically designed to increase my chances of conceiving. It simply isn't needed.
I refuse to believe that one doctor can know everything about everything so I do my homework before each appointment. The conversations I have with my Endocronologist are at a very high level and specific to the treatments that I feel will help me to be healthier and more comfortable with myself. Sometimes, I feel that I know more than he does but he is willing to listen, and to take my research further and, if we agree that a new treatment is appropriate for me, we try it.
Don't expect to get all the answers on your first appointment abd agree a future appointment to review test results/treatments/concerns/questions before you leave the first one.
Go to every appointment with an idea of what you want to achieve in getting a PCOS diagnosis and treatment.
Don't be afraid to let your doctor know if you think there is something else that could be done or something that shouldn't be done. No doctor is perfect and if you find that yours is unable or unwilling to answer your questions then you may want to consider changing doctors or getting a second opinion.
Be willing to give the treatment you've agreed a fair try. Some of the medications take time to work and may initially have some side effects. Metformin in particular can be difficult to take at first, but it is one of the most effective and used treatments for PCOS. Insist on an extended release version, it will make it much easier for your body to get used to it.
It's your body, and your responsibility make sure that you get what you need.
Dx a year ago, but never had blood work? 
if you arent happy with your dr you could change dr. I had to get a new dr to get any pcos help.
