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PCOS, Hirsutism, Cyst, Leaking Sore Breast, Hair Loss. History Of Hypothyroidism, ADHD. Best Options?

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Posted on Sun, 10 Jun 2012
Question: Hi, I am almost 37, 2 children and don't want more/married, 5"8, 140 lbs, Hypothyroidism on Synthroid 112 mcg, ADHD-Adderall 20 (low dose), LPR reflux- Keflex-60, Vertigo, Allergic Rhinitis (mostly dust mites)-allergy shots, & PCOS. All of these issues seem to be genetic...other siblings and parents have various combinations of these. I eat very healthy, physically active and take supplements recommended by my Endo (B12, multi, calcium/D3-Lactose intolerant). I recently started taking magnesium for heavy clotting periods and the problem went away....hmmm. However, the rest of my PCOS symptoms are problematic (hirusitism, cyst, sore breast that leak, excessive hair loss, irritable). This is most of the month...I get a one week break about 3-4 days into my period and ending about the 10th day after period starts. I feel pregnant the rest of the month. I've had these problems most of my life and it cycles depending on things such as prenancy, bcp, breastfeeding...eventually when those three have been history for year or two, my symptoms come back with a vengence. No sugar/insulin issues (68-79 range), nor any family history of this. Last full panel labwork was good in all areas (cholesteral, sugar, thyroid, etc.). Sister and mother diagnosed with PCOS as well. So, what are some of my options for PCOS...or should I say...what are my best options, considering the rest of my history?
doctor
Answered by Dr. Meenakshi Titoria Sahu (3 hours later)
Hi,
Thanks for the query.

With hirsutism, discharge from breast, past history of excessive bleeding and PCOS(poly cystic ovarain disease), i would advise you to check your prolactin, total testosterone and DHEAS (dehydroepiandrosterone) hormones level in consultation with your Endocrinologist or Gynecologist.

Also get your USG (ultrasound) done for uterus and ovaries.

After these investigations, they may put you on hormonal treatment which will depend on your reports.

Hormonal treatment is required for long period around 6 months or so.

Hope i have answered your query.I will be available for follow up.

Best wishes,
Above answer was peer-reviewed by : Dr. Radhika
doctor
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Follow up: Dr. Meenakshi Titoria Sahu (2 hours later)
Hi, so far that is the recommendation from my GYN but when I research the safety of hormonal treatments (birth control/ Estrogen/Progesterone) for women over 35, there is typically a warning. I'd also like to know which hormone treatment would be the most effective with the least amount of serious side affects. I know I have cyst because they were present in ultrasounds with both pregnancies and on another occasion (annual exam). Most of my cyst likely go away after a month or two, but then I get more. I'm considering LoSeasonique for continuous use, if I decide to take the hormone route, but would like to know if that is a safe option for me since I am over the age of 35. I don't have any of the risk factors associated with problems w/ pills (i.e. high blood pressure, cholesterol, smoker, etc). I am mainly concerned with taking hormones after the age of 35 and need a general idea of my risk if I choose to go this direction. Looking at my medical history and age, do you think I have any real concerns with taking LoSeasonique?
doctor
Answered by Dr. Meenakshi Titoria Sahu (2 hours later)
Hello.

Thanks for writing again.

Your doctor will help you in choosing a best hormonal pill depending on your investigations report.

In my opinion she may put you on low dose Estrogen and Drosperinone/ Cyproterone acetate combination.

In your case, the only risk factor is age, taking a hormonal pill in low dose for short term will not cause any major risk.

Regarding Loseasonique, it is good for contraception but in your case the combinations I have mentioned above are more suitable.

I hope, I have answered your query.

Wish you good health.

Regards.
Above answer was peer-reviewed by : Dr. Jyoti Patil
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Answered by
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Dr. Meenakshi Titoria Sahu

OBGYN

Practicing since :1999

Answered : 158 Questions

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PCOS, Hirsutism, Cyst, Leaking Sore Breast, Hair Loss. History Of Hypothyroidism, ADHD. Best Options?

Hi,
Thanks for the query.

With hirsutism, discharge from breast, past history of excessive bleeding and PCOS(poly cystic ovarain disease), i would advise you to check your prolactin, total testosterone and DHEAS (dehydroepiandrosterone) hormones level in consultation with your Endocrinologist or Gynecologist.

Also get your USG (ultrasound) done for uterus and ovaries.

After these investigations, they may put you on hormonal treatment which will depend on your reports.

Hormonal treatment is required for long period around 6 months or so.

Hope i have answered your query.I will be available for follow up.

Best wishes,