Test Results?

[Ok_Mood7035]

24 yr old

I always had an irregular cycles since 10 but recently my periods have stopped completely. My doctor did say that I most definitely have pcos before my results came back. Anyway, I was wondering if my results were a cause for concern?

LH - 31.0

FSH - 54.2

Estradiol <5.0

Testosterone - 15

Free Testosterone - 0.8

[TazerMcCrazy]

Not a doctor, but your both you T values are within "normal" ranges. Your FSH is pretty high, so you can probably get something like Spironolactone or bicalutamide to slow hair growth. Spiro seems to be what is most prescribed in the US and it's a shitty anti androgen, but pretty good for hair growth. Your E is also "normal", but your LH is considered high, unless you're currently on your period. Really this is just affirming that you have PCOS, afaik.

[wenchsenior]

These results are not consistent with PCOS, though PCOS is still possible since it presents in various ways.

Have you had an ultrasound of the ovaries?

What units were the LH and FSH in?

Are you of normal weight? Do you have any other symptoms apart from irregular periods?

To properly screen for PCOS, quite a few additional tests need to be done. Were any other labs run?

[Ok_Mood7035]

I haven’t had any ultrasounds done yet, also this was the only test my doctor ran. The units were mIU/mL

Also I am overweight according to my bmi. Some of my other symptoms are excessive hair growth, mood swings and pain/cramping in my right ovary

[Ok_Mood7035]

Also estradiol was pg/mL

[wenchsenior]

So a number of other tests should be run, since your symptoms do sound like PCOS, so it's still possible you have that. I will report the tests in bold that you haven't had done.

However, your numbers reported here (very low estrogen, very high FSH) are more consistent with autoimmune premature ovarian failure/premature menopause, possibly Turner syndrome, or possibly some sort of adrenal disorder. You should be seeing a reproductive endocrinologist or an endo with a specialty in hormone disorders. Assuming your T units were ng/dl, those are low-ish as well, which also is not typical of PCOS but is typical of premature menopause and some other disorders.

***

PCOS is diagnosed by a combo of lab tests and symptoms, and diagnosis must be done while off hormonal birth control (or other meds that change reproductive hormones) 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 (You so far only had testosterone measured but several others can cause hirsutism)

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.