Thin Cyster - LH:FSH ratio of 2:1 and irregular periods

JMac30 · 04-28-2009, 12:27 AM

Hi ladies,
I just thought I'd introduce myself and I would love to meet other "thin cysters" and hear your stories.

So - here's my story... I am a normal weight. At times I was even called skinny. I gained a bit of weight in my later 20's but am still in a healthy weight range (BMI of about 23). Prior to going on the pill I had normal cycles. I was on the pill for 11 years, going off it a year ago at age 29 as my dh and I were wanting to ttc. My first cycle off the pill was 51 days long. I took 5 pregnancy tests because I didnt know what was going on. I started charting my temperatures the 2nd cycle. it was another 51 days but showed I ovulated on CD40. I went to my doctor about my long cycles and he told me it was probably just my body adjusting to being off of the pill. I asked him about PCOS but he told me I wasnt overweight and didnt have male-type body hair, so I wouldnt have PCOS....

My third cycle off bcp was only 40 days, I ovulated on CD 30, hooray, they were getting shorter!

My fourth cycle was super long though, I didnt ovulate until CD58. BUT, it turns out, we "caught the egg" and I was pregnant!! We were THRILLED. I had no problems except for some light pink spotting at about week 10 of pregnancy. I went in for an ultrasound at 11 weeks and the u/s showed the baby was measuring at only 7 weeks and had no heartbeat.

I had to go in for a d&c for the missed miscarriage on Jan 22, 2009.

I have since then been charting and waiting to ovulate. As the weeks went by and nothing happened, I started to get frustrated. I decided to go see the OB who consulted me on my d&c. I am SO glad I did, because I know my regular family doctor would not have taken me seriously, since I dont appear to have the physical characteristics common to PCOS.

The OB sent me for bloodwork, and I got the results back two weeks ago now. He told me most of my bloodwork came back normal, EXCEPT my LH to FSH ratio was 2:1, which indicated PCOS. Wow. I was prepared because I knew my cycle characteristics were very indicative of PCOS (long cycles, delayed ovulation, multiple patches of fertile cm) but it was still a bit of a shock.
He told me my androgens were normal and my glucose was normal. I did get a fasting insulin test done but the results werent in yet.

So I am here trying to find all I can about it, and do anything to prevent symptoms from worsening, and try to get better if I can at all.

I am still in a healthy weight range but I could definitely stand to lose 5-10 pounds or so. I notice I have a lot more "girth" in my abdomen that has happened since the pregnancy and not gone away.

The OB prescribed me progesterone pills which I took daily for 10 days. I finished the last pill Friday night and I started spotting a little bit yesterday and today, but I am still awaiting my "official withdrawal bleed".... It has been 96 days since my d&c.

My OB said I can go on Clomid if I like, but I think this next cycle I want to do all I can to lose a few pounds, and I am going to try acupuncture. I also had a naturopath recommend Vitex, has anyone had any luck with that?

After reading some of the research throughout this site, I wonder if I should consider metformin? My OB only mentioned Clomid as an option?

Anyway, I rambled on, sorry! Lovely to meet all of you and I would love to hear of your experiences.

almatea · 04-28-2009, 01:38 PM

Hi JMac,
We have a similar story. I just turned 33 and have been struggling with this for 15 years. It took me 10 years to get properly diagnosed, but even after that proper treatment was hard--though I was on the pill and that helped manage my symptoms.

I'm pretty thin, the facial hair only started getting bad recently, and although my scalp hair was thinning for years no one beleived me! I can't tell you how many times my thyroid was tested! Anyway...

I did a lot of research and tried to get on Metformin before my hub and I conceived, but no luck. I also had a missed miscarriage at 9 weeks. That ultrasound was heartbreaking...as was going home and telling the so-eager-to-be-a-dad guy who as soon as I walked through the door said, "how is the little guy doing?". Ugh.

Definitely go on Metformin - I am in the health field and have done a ton of research. I am demanding it of my doctor as soon as I get an appointment--I don't want to question if getting put off again will end another pregnancy. Even with "normal" insulin, Metformin seems to help. Check out the other posts and resources: physicians think if we're think we're not IR. But even if we're not, Metformin helps with the androgenization, regular cycles, egg quality, etc. etc.

The good news is we could concieve. I told my husband I am going to be the most difficult paitient ever if that's what it takes to get metformin. Also, I think I will ask for progesterone supplementation if/when I get pregnant again, at least through week 12.

Good luck. I'm new too! Let's be moms!

anselmi · 04-28-2009, 06:27 PM

Hey, sorry about your loss. I have insulin resistance and was told by my doctor and fasting glucose blood tests that if i just keep a healty diet, my insulin levels stayed under control and there was no need for met. From what I have read it has a lot of side effects. Also, I'm a big believer that less medicine is better. If you don't have the symptoms dont take it. From what you have said, it sounds like you are ovulating, just late...which is a great sign because a lot of us here dont even get that! I would definately pay attention to your progesterone level after ovulation. There are many reasons why you may have lost your baby, but one of them could have been a uterine infection (which I think they check for in your 6 week blood work) and also low progesterone levles...i know there are more reasons, thats just the ones I know about. When you get pregnant next time, you should make sure that your doctor keeps a close eye on your progesterone level weekly until you get to your second trimester. If you dont have the proper progesterone support, your lining will not build up properly. It is just one thing to consider when you get pregnant again...its definately not the whole picture.

Also, make sure your doctor is well aware of everything involved with pcos. If he/she isn't, you may want to visit with an Reproductive Endocronoligist. They deal with this every day.

Many women also ovulate in a normal cycle with clomid, you should give it a try before you keep adding extra medicine. It is important to be patient!

Best of luck!

girl · 05-06-2009, 04:54 AM

my LH is 6.0 and FSH 2.8
so my lh to fsh ratio would be 2.1:1 what does this mean?

Search4Truth87 · 05-07-2009, 08:35 PM

Girl,

The normal LH:FSH ratio is 1:1, except during ovulation when LH surges. So, that could mean that your LH level was beginning to surge because of ovulation, or it could be indicative of PCOS or another hormonal imbalance. Did you discuss this with your doctor?

girl · 05-08-2009, 03:17 AM

i hadnt had my cycle for a few months and then this bood test was taken the day before i finally got it so i dont know if that affects LH?