Hi, I originally posted this in what's on your mind, but I'm not getting any replies, so I will try over here.
Hi everyone! I was just dxed last Monday, after having an ultrasound and some bloodwork. I went in for my results and the US showed a thickening, and the dr wanted to do a biopsy right then and there. I was so dumbfounded I didn't think of the PCOS or questions at the time. My biopsy results turned out fine. So now I am focusing on the PCOS and I don't know if I am happy with the tests the dr did.
First let me say that I am not overweight, though I am in the upper weight range for normal. I am 5'6.5" and weigh 152 lbs. I lost 30lbs this past winter. I do have the fat around the belly. My periods are NOT that irregular. In fact, I just went back to January(9mos) and looked, to be sure. I had one month at 28 days, 3 at 27 days, and one each at 26, 25, 24, 21, 20 days. The reason the dr did the US was due to "heavy menses". In reality, most are not super heavy, they last 7 days, and every now and then I have one that is awful, and I pass what looks like endo. tissue with clots. I do believe I am ovulating, atleast part of the time, because I often get mittleschmirz, which is pain on ovulation.
The only bloodwork the dr did was CBC, which was normal, TSH, also normal, and LH & FSH. I am not quite sure how to interpret these. It was drawn on the 23rd day of a 28 day cycle. This is during the luteal phase, correct? the ref. range for that phase for FSH is 1.5-9.1. Mine was 2.0. The ref. range for LH during that phase is 0.5-16.9. Mine was 1.6. Aren't these normal? Or do I have the wrong phase? I started my period 5 days after the blooddraw.
The US showed the right ovary was 4.4 x 1.3 x 2.2. The left was 3.3 x 2.7 x 1.9. It said the ovaries contain follicles, and they are unremarkable.
These are the only tests that were done. The dr gave me a script for Metformin and for Prometrium, neither of which I have started yet, because I wanted to post here, and get your opinions. Oh, also, he said he wasn't going to put me on BC, because I smoke. Then when I called for my biopsy results, he added the prometrium to the metformin. I'm not happy about the prometrium at all. In fact, I'm not happy about the metformin either, lol. I am not happy about any of this, as I guess you all know. Also, I have two children, ages 15 and 4.
Thanks for reading all this, lol!
Rhonda
ETA: dr is obgyn, and shouldn't the dr do many more blood tests, including a insulin check before i take metformin?? Also, I do have sx, such as too much hair, hair on head falling out, fatigue. I also have fibromyalgia, which I thought the fatigue came from that. My dr did not know of any of these sx, becuz I never knew they meant anything.
I am a big supporter of going to see an endocrinologist as well as an OB/GYN for PCOS treatment. Many symptoms or affects cross both lines...check out www.aace.com for a recommended one. There are also threads on this site that discuss people's personal experiences with doctors.
In my opinion -- I have to preface it that way as I'm no doctor, the tests weren't extensive enough to dx PCOS even though it may be correct. It sounds like your doctor just deferred to that...there are so many areas that can impact your treatment that just running the "basics" isn't sufficient. I would also look into some of the books available on PCOS. Many of them list appropriate tests and what the results mean in your dx. At the very least, you should have had a fasting test with insulin and blood sugar levels.
There are also a number of good threads on this site relating to diagnosis -- check them out as well. Good luck!!
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Dx: 8/28/06
Met - 2000mg, Norvasc 5 mg
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One Furbaby --Freckles the Wonder Dog---
is now an AVATAR!!
Rhonda,
Welcome here to SC!
I really hope that you find the answers that you are looking for.
For the record I totally agree with Susan.
Good Luck to you!
I pretty much have decided to call an endocrinologist. I am not going to take the meds until I see him. How do I explain that to my obgyn, though? I am supposed to go back there in four months. I will probably just tell him that after doing my own research, I felt like I needed more testing, and decided to see an endo. I adore my ob/gyn, but I just feel like more needs to be done test wise.
Thank you Jenny, for the warm welcome & for the info. I have read all over this site over the last few days. I was getting ready to call the endo, and my hubby said I should call my ob/gyn first and ask him why he didn't do the other tests, and go that route first. I'm not sure what I'm going to do, I guess it will wait til Monday now.
I think I may agree with your hubby. If you really like your ob, call and ask about why they did the test they did and ask about others you're intersted in. But, with a diagnosis as significant as PCOS can be, it's alway in your interest to get a second opinion. I love my RE and am so happy I made the choice to make the appointment with him. I feel like he understands my issues better.
Also, I think that with the blood work it can be that the levels are really off or that they're in the normal range but the ratio is really off. Or something like that! =^)
Good luck with everything!
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Soapy, I DO love my ob. As a matter of fact, someone on this site put him in the recommended doctors. When they did, they said he referred her to an endocrinologist, which he didn't do with me, not sure why. Let me ask this...do I need to see an endo, or a rep. endo? I am not interested in having anymore children, so I wasn't sure if just an endo would be ok. I have one in mind, he is on this site also, I've heard good things about him from a friend.
So, with my ob, I should just call and ask why he didn't run an insulin test, and what others, hormones? such as testosterone? I guess I need to go reread the test page, lol.
Also, does anyone know how to figure out the LH/FSH ratio? I can't find anything on it.
I've heard that the reproductive ones are more in tune with PCOS but that's only anecdotal. I posted somewhere else tonight about seeing my RE before we were interested in trying for kids. While he mainly does the pg thing, he'll see me for my PCOS and endo even if I decide not to have kids.
Maybe your doc didn't refer you since she/he knew you didn't want anymore kids?
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Thanks again. I don't know if that's the reason or not on the referral. He does know I don't want more kids, simply becuz it's a running joke, becuz my sister has 6 and will probably be back again, lol. My kids are 11yrs apart, and the first one was supposed to be the only one ! So he asks me every visit if I'm pregnant. He never asked me ANY of these questions that are pertinent to PCOS. He simply did an U/S and the LH/FSH.
Jenny, I was actually just looking at that link, lol. From what it says, my LH/FSH are NORMAL. My US says the ovaries contain follicles. Doesn't say how many, says they are unremarkable. This coupled with the fact that he never asked questions, and only did these two tests, along with TSH and CBC, HOW did he come to this dx?
Even at that, after all my reading, I guess I probably DO have PCOS. But shouldn't my insulin be tested BEFORE I start Metformin, so we know what it is, and if it's improving on the Met?? I'm getting angry with my doc, for not discussing any of this with me. Instead, he laid a biopsy on me, scared me to death about cancer, gave me a script for Met and sent me on my way. He decided against BCP becuz of smoking. THen when I called for results, he also called in prometrium, which I have no intention of taking right now. Also, if I DO have PCOS, is it absolutely necessary to take prometrium?? Or can I just do Met to start off?
Well, since the u/s doesn't say how many follicles there are, it could be that the ultrasound is his main reason for diagnosis. The PCOS ovary produces follicles each month that don't mature enough to be released and so essentially, the ovary would have many follicles or follicular cysts. My original obgyn did test me for insulin resistance, which I didn't have. The RE, who is far more knowledgable, has not. There are many women on met without the IR factor because it helps balance out hormorne irregularity.
I've personally never had to take prometrium but met may take awhile to kick everything in gear for you. You may need both but I'm certainly not qualified to give anything more than my opinion!
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Thanks soapy! So essentially, I should probably go ahead and start the Met. Between what you are saying and all the reading I did last night, it sounds like either way, it's one of the best treatments.
Last night I was reading on Dr. Vliet's website, which I found from here, and the things she is saying about hormones makes so much sense for me. I have fibromyalgia, and geez, all the symptoms she has listed for hormone imbalance fit me to a tee. So, I will start the met, and I will call my ob tomorrow, and set up a consult to talk about testing all these hormones. I'm hoping he will be open minded enough to go along, and I'm actually a little excited, because if my fibro is due to hormones, OMG, there may actually be a chance that I could get better. That would mean no more, or much less pain. I can barely comprehend the thought!!!
Newly diagnosed...major questions!! (thread #2) 
! So he asks me every visit if I'm pregnant. He never asked me ANY of these questions that are pertinent to PCOS. He simply did an U/S and the LH/FSH. 
