Neena

Thanks, Nat.

Please try to contact your Primary care Physician and see if he/she can refer you to an Endo first. You most likely will need a doctor's referral before you can see the Endo.

You might want to go see the OB and try to get a referral first. We had to wait three months to get an appointment with an Endo (Dr. Dunaif in Chicago). I don't know whether your OB knows a lot about PCOS, but if she does, she will definitely try to put you on some medication to control the PCOS symptoms (Metformin or something similar) or refer you to someone who can (if she goes the birth control route and gives that as your only option, you know you need to switch doctors.) If not, then I'd get a referral from whomever listens and go see the Endo. I know its hard to go through new doctors and try give them your history. I went through four doctors in three months. Please do make sure you also get the Insulin Resistance test done and a detailed Thyroid check (including anti-bodies, not just TSH).

Best wishes.

__________________
TTC #1 Jan 07; Chem. preg Jun 07
1/14/08: BFP-no meds (diet, cinnamon, flax oil+castor oil from CD 6)
1/18/08: Beta: 1157 (18dpo) Brown spotting; DX with Sub. Hypothyroid at 1st Endo visit
1/22/08: Beta: 6000 no HB no fetal pole
1/25/08: Beta: 13900 Red Blood-ER visit; US: no HB
1/28/08: Beta 14100 feared miscarriage
2/05/08: US: HB 128
2/19/08: US: HB 160
3/18/08: Nuchal test-ok; US: HB 170
5/20/08: Level 2 U/S ok; It's a Girl!! EDD now Sept, 15; baby 4 days behind.
orig. EDD: Sept. 25, 08

Natalee

Neena,

I found an OBGYN/ENDO (he is both!) in my area on the PCOS Association website. Believe it or not I was able to get an appt for this Tuesday! I am very blessed to have wonderful insurance through my work that allows me to see specialists without a referral.
I will post after my appt and keep you updated. Thank you again for your kind words and sound advice.

~Nat

just*me

I would definitely recommend talking with your MD about starting Glucophage. I was also on BCP for the majority of my adolesence and young adulthood. My body stopped reacting to the pills after about 5 years of being on them and my DS came along!! Surprise!! After I had him I went on the patch for 5 years. Had to deal with cervical dysplasia and went off the patch to try to give my body a break and only was it then that I realized something was wrong. I got terrible cramps the first month and sharp, stabbing like pains but no period. My Dr. gave me Provera to try to bring on a period and help with what she suspected were cysts (no u/s performed). My body didn't respond to the Provera and my OBGYN wasn't sure what to do so she sent me to a Reproductive Endocrinologist and it was the best thing I have ever done for myself.
I have only been on the Glucophage for 3 months but am beginning to see results and my body generally feels better. I actually sleep and don't wake up in cold sweats or having a hot flash!!
Good luck and keep us posted on what you find out!!!

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DS born 4/26/02
DX PCOS 6/2007
Failed Provera to induce AF
Found wonderful RE 1/2008
HSG & Lap 2/2008
Follistim & Ganirelix = IVF #1 April 2008, BFN
FET #1 canceled 5/2008, no follies made it to blast..
FET #2 canceled 6/2008, lining only .45 on CD 12....
FET #3...7/08... waiting for AF to start

Neena

Dear Nat,

I am glad to hear that you found an OBGYN who is also an RE. I hope you get the proper treatment. Best wishes.

__________________
TTC #1 Jan 07; Chem. preg Jun 07
1/14/08: BFP-no meds (diet, cinnamon, flax oil+castor oil from CD 6)
1/18/08: Beta: 1157 (18dpo) Brown spotting; DX with Sub. Hypothyroid at 1st Endo visit
1/22/08: Beta: 6000 no HB no fetal pole
1/25/08: Beta: 13900 Red Blood-ER visit; US: no HB
1/28/08: Beta 14100 feared miscarriage
2/05/08: US: HB 128
2/19/08: US: HB 160
3/18/08: Nuchal test-ok; US: HB 170
5/20/08: Level 2 U/S ok; It's a Girl!! EDD now Sept, 15; baby 4 days behind.
orig. EDD: Sept. 25, 08

Natalee

So, I had my doc appt yesterday and was diagnosed with PCOS. He also thinks I might have Endometriosis. He put me on 45mg Actos and Flutamide (can’t remember the dose). I really really really liked this doctor. He just sat and talked with me for an hour and a half. We went over my symptoms and he explained everything in such detail (he even drew me pictures). However, he diagnosed me as being insulin resistant without even taking my blood. Is this common? (He is a specialist with PCOS and is a member of the PCOS Association.) After he explained what IR is and how it is affecting my hormones, I asked him if he needed to do any blood work. He simply stated that my symptoms and face told him everything he needed to know. Again, is this common? Will it hurt me if I am taking Actos and am not really IR?
I started taking Actos yesterday and I feel a bit light headed and dizzy. I have sweat less than normal today (which is great), but besides that, I just feel out of it and absent minded. Is this my body just adjusting to the medication?

Thanks!!

Bella35

Natalee, I would definitely recom. BW regardless of what the Endo is telling you. BW will also rule out Hypothyroid... Additionally, I recommend a transvaginal ultrasound to rule out anything else.

Good luck !!

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Letty ~ 33
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Marco ~ 32
TTC: Jan. 2008
DX: PCOS & Hypothyroid (04/08)
RX: Met 2000MG - since 04/08
RX: Synthroid 75MG - since 05/08
Other Meds: Prenatal Vit.
Next Appt. 10/17 with Endo.


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AnotherDreamer

I agree with PP.
Get some BW to correlate, and also make sure everything gets looked at (ultra sound, BW for testosterone LH IR Etc., check thyroid... just some suggestions.)

good luck with everything.

__________________

Neena

Dear Nat,

My RE-Andrea Dunaif is a very well-respected doctor in PCOS. Unfortunately she was unable to put me on medicine since I was pregnant already, but she did say I could come back after I finish breastfeeding and then she might consider me for Metformin. She does a lot of research in the field and she told me that Metformin is no longer considered safe during pregnancy and she explained that the miscarriage rate was actually higher in their study (I was taking cinnamon and I was told to stop and I worried that if my testosterone went back up, I might miscarry). I did have bloodwork done five years back which showed elevated testosterone, irregular periods, physical symptoms, and U/S showed cysts. I was not and am not IR. Dr. Dunaif did do a glucose tolerance test and complete blood work just as my GYNO did five years back.

I think a doctor with a lot of experience can use physical symptoms such as dark line on your neck, waist to hip ratio, fatigue after meals, abdominal fat etc, and dx you with IR. However, considering that doctors kept missing my Hypothyroid (can cause brain defects in fetus) for a year (it was within the range for a normal person, but out of range if they applied pregnancy stds and we were TTC), I would still insist on some blood work. Dr. Dunaif said she would like it to be around 2 during pregnancy.

Since I have never been on anything other than the BCP, I can't answer your previous question regarding the Meds. Hope this helps in your decision to get bloodwork.

All the best,

Neena

Neena

Also, from my own research I do know that Insulin Resistance can be missed in BW and gulucose tolerance is not the best test for it. And there is no great test for Endometriosis. I think there is a section on this site which deals with this condition alone. Hope you can get some answers there.