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Dr. Andrew Rynne

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What are the symptoms of PCOS?

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Dr. Shanti Vennam

OBGYN

Practicing since :1989

Answered : 7304 Questions

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Posted on Tue, 5 Aug 2014 in Women's Health
Question: My OBGYN doctor thinks I have PCOS but I'm not so sure.

PCOS Sympotoms:

- Elevated LH levels 15.8 (FSH is 6.5) - but this is not dependable since it who knows where I was in my "cycle"
- I stopped birth control pills 8 months ago and haven't had a period in the last 5 months
- Ultrasound shows polycystic ovaries (but not necessarily PCOS)
- Acne on cheeks and chin (started about 6 months ago)

Reason I believe I may be misdiagnosed: (all the following are within normal range)
- Normal hemoglobin A1c levels (5.4) - no or little risk of diabetes
- Cholesterol 161 total
- Triglycerides 127
- HDL cholesterol 52
- Free testosterone 0.7 (normal range is 0-2.2)
- Testosterone, TOTAL LC/MS 43.4 (normal is 10-55)
- DHEA-sulfate is 253.5
- estradiol 34 (depends on cycle - which I haven't had in 5 month so it's difficult to tell if this is normal or not)


I'm 5'5'' and about 130 pounds so not really overweight. Does this sound like PCOS or something else? I feel like I should get a second opinion but who would I go to?

PCOS generally is associated with excess hair growth and androgen (testosterone) which neither I have.
doctor
Answered by Dr. Shanti Vennam 41 minutes later
Brief Answer:
PCOS seems to be the likely possibility.

Detailed Answer:
Hi,

Thanks for trusting us with your health query.

By definition, PCOS means oligomenorrhoea or scanty periods, hyperandrogenism in the form of acne or hirsutism and hypernadrogenemia shown as elevated free or total testosterone and DHEA-S levels.

The rest of the features need not necessarily be associated with this condition. They include hyperinsulinemia or excess insulin, insulin resistance, elevated LH-FSH ratio, infertility, abdominal obesity and polycystic ovaries on sonogram.

You have scanty menstruation, acne, elevated testosterone levels, which are the salient features in addition to polycystic ovaries on ultrasound and elevated LH levels.

Yet, your lipid values are essentially normal and you have a normal BMI. It is not necessary for all those with PCOD, to have excess hair growth nor to be obese.

So, based on the reports and the clinical findings, it is most likely to be PCOS. Please do not worry, as it is a condition that can be easily cured by medication. Please follow your doctor's instructions.

Hope I have clarified your query. Please feel free to contact for any more information. I will be happy to help.

regards,
Shanti.V.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Shanti Vennam 45 minutes later
But I do NOT have elevated total testosterone and DHEA-S levels.
doctor
Answered by Dr. Shanti Vennam 7 hours later
Brief Answer:
Can have additional investigations.

Detailed Answer:
Hi,

Thanks for your feedback.

You are right, you do not have elevated testosterone and DHEAS levels. Yet, based on my clinical experience and your symptoms, I am in favor of the possibility of PCOS. According to the Rotterdam criteria, any two of the features -androgen excess, polycystic ovaries or ovulatory dysfunction, are sufficient to come to a conclusion. You can also get the AMH levels tested, dexamethasone suppression test and free androgen index.

If you have always had regular cycles without the use of pills and this amenorrhea is a recent development, then, observation is necessary to conclude on the diagnosis. I am not able to read your reports as they have failed to upload. Please inform the same to customer care.

Hope I have answered your query. Please get back for further clarifications. I will be ready to help.

regards,
Shanti.V.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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