If you have read my posts before, you will know that I was diagnosed with PCOS in 2006. I was an overweight child and teen. No matter what I tried, I couldnt' seem to get my weight down. I am 5'4" and hovered around 150-160lbs despite my mom's many attempts to put me on a diet. My cycle started late at the age of 14 or 15 and was never regular. I started getting noticeable (though light coloured) facial hair when puberty started. I still when I was 12 my sister ran through the house telling everyone that I had a mustache.
I started exercising regularly for fun and stress management in university and started eating better and for the first time ever I lost weight. But my cycle was still highly irregular. In fact, in university, I would often get my cycle every week or two and bleed for 2-4 weeks at a time. It was awful. I also started getting long darkish hairs on jawline and under my chin that I plugged. I was already trimming my "mustache" with scissors on a daily or every other day basis. I saw the campus health care provider about my cycle and was instantly put on the BCP (no blood work was done). I was on the BCP from 2000-2005.
During that time weight loss was a breeze! I did end up with an eating disorder and got down to 100lbs at 5'4" and my cycle completely disappeared. I came back from that my weight sort of stabilized at around 130lbs. I was still on the BCP and my cycle was back to being regulated by it.
Then in 2006 I went of the pill as my boyfriend at the time and I decided we wanted to try to have a baby. My weight became unstable again. I struggled with binge eating - especially on carbs and sugar. 3 months after coming off the pill I still hadn't had any signs that my body was gearing up to ovulate. Then in September, 4 months after being off the pill, I ended up in the ER with a ruptured ovarian cyst.
My health was put into the hands of a gynecologist who wanted to address the cause of the cyst. She took my history. I told her about my irregular periods and the facial hair. I also told her about my eating disorder. She sent me for blood work and an ultrasound. Here is what both showed:
Ultrasound
Feb 2, 2006
right ovary: 4x1.9x3.3cm, volume 12.54
left ovary: 3.5x2.8x1.8, volume 9
volumes normal
rounded appearance, more than five follicles in each ovary predominantly situated peripherally
increase in stromoal echogenicity
Bloodwork
FSH 7 iu/l
LH 2 iu/l
prolactin 5 ug/l
total testosterone 141 ng/dl
free testosterone 1.1 pgml
fasting insulin 5.9 uiu/ml
TSH 2.49 miu/l
She told me my Lh:FSH ratio, my ultrasound results, and my high total testosterone along with my hair growth and the results of my ultrasound all indicated I had PCOS.
She told me i'd never get pregnant on my own and that I needed to either take the BCP or use provera every 3 months if I didn't get my cycle on my own. She also told me that diet, exercise and weight loss were crucial in improving PCOS symptoms. Even though I was a normal weight (130lbs at 5'4"), she told me a 10% reduction in my weight could change my hormonal profile dramatically.
For past 9 years I have used diet and exercise to "manage" my PCOS. My cycles are still irregular (36-90 days long). I have had my hormones retested at regular intervals and my testosterone has come back within the normal range each time (though my LH:FSH ratio is still off). I have been pregnant three times, all naturally (1 ended in miscarriage, 1 is now a happy 18 month old and I'm currently 36 weeks pregnant).
My question: was my initial diagnosis correct?
Knowing what I know about PCOS now, I would say it probably is, but I'm curious because my blood has all been normal since July 2008 (which is the last time my testosterone came back high - during a period of less controlled eating and weight gain). But my free testosterone has never been high and I thought that in PCOS it is usually high? I have been tested for NCAH and that came back negative. Does the criteria used for my initial diagnosis clearly show PCOS?
I started exercising regularly for fun and stress management in university and started eating better and for the first time ever I lost weight. But my cycle was still highly irregular. In fact, in university, I would often get my cycle every week or two and bleed for 2-4 weeks at a time. It was awful. I also started getting long darkish hairs on jawline and under my chin that I plugged. I was already trimming my "mustache" with scissors on a daily or every other day basis. I saw the campus health care provider about my cycle and was instantly put on the BCP (no blood work was done). I was on the BCP from 2000-2005.
During that time weight loss was a breeze! I did end up with an eating disorder and got down to 100lbs at 5'4" and my cycle completely disappeared. I came back from that my weight sort of stabilized at around 130lbs. I was still on the BCP and my cycle was back to being regulated by it.
Then in 2006 I went of the pill as my boyfriend at the time and I decided we wanted to try to have a baby. My weight became unstable again. I struggled with binge eating - especially on carbs and sugar. 3 months after coming off the pill I still hadn't had any signs that my body was gearing up to ovulate. Then in September, 4 months after being off the pill, I ended up in the ER with a ruptured ovarian cyst.
My health was put into the hands of a gynecologist who wanted to address the cause of the cyst. She took my history. I told her about my irregular periods and the facial hair. I also told her about my eating disorder. She sent me for blood work and an ultrasound. Here is what both showed:
Ultrasound
Feb 2, 2006
right ovary: 4x1.9x3.3cm, volume 12.54
left ovary: 3.5x2.8x1.8, volume 9
volumes normal
rounded appearance, more than five follicles in each ovary predominantly situated peripherally
increase in stromoal echogenicity
Bloodwork
FSH 7 iu/l
LH 2 iu/l
prolactin 5 ug/l
total testosterone 141 ng/dl
free testosterone 1.1 pgml
fasting insulin 5.9 uiu/ml
TSH 2.49 miu/l
She told me my Lh:FSH ratio, my ultrasound results, and my high total testosterone along with my hair growth and the results of my ultrasound all indicated I had PCOS.
She told me i'd never get pregnant on my own and that I needed to either take the BCP or use provera every 3 months if I didn't get my cycle on my own. She also told me that diet, exercise and weight loss were crucial in improving PCOS symptoms. Even though I was a normal weight (130lbs at 5'4"), she told me a 10% reduction in my weight could change my hormonal profile dramatically.
For past 9 years I have used diet and exercise to "manage" my PCOS. My cycles are still irregular (36-90 days long). I have had my hormones retested at regular intervals and my testosterone has come back within the normal range each time (though my LH:FSH ratio is still off). I have been pregnant three times, all naturally (1 ended in miscarriage, 1 is now a happy 18 month old and I'm currently 36 weeks pregnant).
My question: was my initial diagnosis correct?
Knowing what I know about PCOS now, I would say it probably is, but I'm curious because my blood has all been normal since July 2008 (which is the last time my testosterone came back high - during a period of less controlled eating and weight gain). But my free testosterone has never been high and I thought that in PCOS it is usually high? I have been tested for NCAH and that came back negative. Does the criteria used for my initial diagnosis clearly show PCOS?
Just trying to understand my initial diagnosis. Can someone help?
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