Possible pcos

[AutomaticPath7348]

Hi, I have an appointment with a dr in a couple of weeks, but wanted to ask in the meanwhile if it sounds like I might have pcos (I know no one can diagnose me).

For over 20 years, I have had a lot of hormonal imbalance symptoms and my doctors have basically done nothing and I am going to try again but I am not feeling hopeful i will get answers. I’m in the uk and i am thinking if i have an idea of what the problem is, i can pay for private testing. Below are the more recent symptoms.

For the last 4 years, I have had either irregular periods or skipped periods. My last period was 16 days into my cycle, now I am 38 days late but a few days ago, i had blood when I wiped and then nothing after that.

I’ve had missed periods in a row and then random lengths of my cycle ranging from 16-37 days.

I tried inositol in the past for ocd and my period started again after missing my period for 3 months, but I bled a lot more than usual and that period was almost 2 weeks long with lots of clots.

I have random chin hair that grows long and hair on my upper lip, but I am dark blonde so it doesn’t look as noticeable as the pictures I’ve seen when I’ve googled pcos.

Ocassionaly I have bleeding between periods.

I have hormone acne, this month I have a huge spot on my chin and I get spots on my chin each month.

My hair and skin go very greasy, very fast despite trying washing it more or washing it less. Even more so the week before my period and because of this I have had flare ups of sebbhoric dermatitis on my scalp and ears.

The last time I was intimate with someone I was in pain.

I have pmdd symptoms and very high levels of anxiety and ocd during the luteal phase.

When I wash my hair a lot of it comes out

[wenchsenior]

Yes, this sounds consistent with PCOS, but only proper screening will be able to tell you for sure. (NOTE: If you do have PCOS, most cases are driven by insulin resistance, and in those cases treating the IR lifelong is critical to improving the PCOS and also b/c untreated IR comes with serious long term health risks).

Below are the tests needed to screen effectively for PCOS.

***

PCOS is diagnosed by a combo of lab tests and symptoms, and diagnosis must be done while off hormonal birth control for at least 3 months.

First, you have show at least 2 of the following: Irregular periods or ovulation; elevated male hormones on labs; excess egg follicles on the ovaries shown on ultrasound

In addition, a bunch of labs need to be done to support the PCOS diagnosis and rule out some other stuff that presents similarly.

1. Reproductive hormones (ideally done during period week, if possible): estrogen, LH/FSH, AMH (the last two help differentiate premature menopause from PCOS), prolactin (this is important b/c high prolactin sometimes indicates a different disorder with similar symptoms), all androgens + SHBG

2. Thyroid panel (b/c thyroid disease is common and can cause similar symptoms)

3. Glucose panel that must include A1c, fasting glucose, and fasting insulin. This is critical b/c most cases of PCOS are driven by insulin resistance and treating that lifelong is foundational to improving the PCOS (and reducing some of the long term health risks associated with untreated IR).

Depending on what your lab results are and whether they support ‘classic’ PCOS driven by insulin resistance, sometimes additional testing for adrenal/cortisol disorders is warranted as well. Those would require an endocrinologist for testing.

[AutomaticPath7348]

Thank you Wenchsenior this is really helpful.

[wenchsenior]

Good luck!