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Dr. Andrew Rynne

Family Physician

Exp 50 years

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OK. So I want another opinion. Female 42(Healthy, No health

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Dr. Mirjeta Guni

Endocrinologist

Practicing since :2006

Answered : 2091 Questions

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Posted on Sat, 12 Jan 2019 in Women's Health
Question: OK. So I want another opinion. Female 42(Healthy, No health issue accept unable to conceive)
Regular periods but Weight gain, facial hairs near chin and thinning hairs.

Yearly blood work done 2 days ago. Cholesterol, Sugar, all chemistry came back normal only DheaS and testosteron levels came back high.
DheaS(14.4 umol/L) and Testosteron(2.1 nmol/L)
I am worried if this could be related to anything serious other than Pcos? I am having hard time conceiving. Had almost same results back in 2008 but later tests came normal.
My doctor said not to worry but how can i not if the numbers are out of normal
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Follow up: Dr. Mirjeta Guni 9 minutes later
Complete report is attached to profile.
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Answered by Dr. Mirjeta Guni 3 hours later
Brief Answer:
About high testosterone and dheas;

Detailed Answer:
Hello and thank you gor asking!
I have gone carefully through your concern.
Having into consideration your previous history and the actual testosterone and DHEAS levels, i would also agree for PCOS as the most probable diagnosis.
Usually in adrenal pathologies DHEAS levels are higher than yours.
You should know that PCOS has a tendency to reactivate or get worsened in the periods of weight gain. Anyway to confirm it you should have 2 out of three criterias(irregular menstrual cycle, hirsutism or high testosterone levels and the presence of polycistic ovaries in the ultrasound), of course other pathologies should be excluded too (tsh, prolactine and adrenal pathologies).
So, i would suggest an abdominal ultrasound (ovaries and adrenals) and to check prolactine and 17 OH progresterone to exclude other pathologies.
Hope i have been helpful.
Best wishes,
Dr.Mirjeta

Above answer was peer-reviewed by : Dr. Nagamani Ng
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Follow up: Dr. Mirjeta Guni 40 minutes later
Thank you Dr.
I will try to convince my Dr for further testing. He did renal(Adrenals) US and Ovaries US 2 years ago and told me there are few very small cysts in one ovary which could be related to pcos, Rental US/Scan looked normal(He again told me yesterday that he is not willing to do more testing) The Tsh/Cortisol were normal.
Appreciate your input.
doctor
Answered by Dr. Mirjeta Guni 19 hours later
Brief Answer:
About high testosterone;

Detailed Answer:
Hi again,

If PCOS in confirmed in ultrasound, then don't worry.

I would recommend losing weight in order to improve the testosterone level and hirsutism.
Probably metformin can help.

Best wishes,
Dr.Mirjeta


Above answer was peer-reviewed by : Dr. Arnab Banerjee
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