Gynecology / Women's Health Expert Forum
Amenorhea, possible PCOS
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Amenorhea, possible PCOS

In August of 2011 I had a physical exam and mentioned to my doctor that I had not had my period in about 3 months. At the time I was in the process of losing weight (I had lost about 70 pounds, I ended up losing 100 pounds total). My doctor said it was most likely due to my weight loss, and once my body adjusted my period would return. In January of 2012 I had my period. I have not had my period since January of 2012. I saw my PCP for a checkup and he was a bit concerned that I had not had my period in so long. He told me it might by PCOS but he referred me to a gynecologist to find out for sure. I saw the gynecologist last week. I told her the date of my last period. She said it was probably PCOS and I could either go on birth control or progesterone for 7 days a month to bring on my period. She did a Pap test but no other tests. She then asked if i wanted to go on birth control or the progesterone. I chose the progesterone since it had the least side effects. I am supposed to start the pills on Wednesday.
I have a few questions. First, aren't there tests that can be performed to find out if it is PCOS? Is it something that is diagnosed based on medical history? Also, is it medically necessary to get your period? I am not sexually active and do not plan on having children. Should I get a second opinion?

Thank you
603463_tn?1220630455
Hi!
If you were my patient I would do some blood tests including thyroid prolactin FSH/LH, and 17 hydroxy progesterone levels.  These tests would rule out other conditions.  PCOS is called a diagnosis of exclusion--once every thing else is excluded you are left with the diagnosis of PCOS.
Yes, it is medically necessary to have a period.  If you don't you can get a build up of tissue in the uterus which can lead to hyperplasia and even in rare cases endometrial cancer.  I would offer you the same two options .for treatment. I think your doctor is right on target, but a second opinion can be reassuring.
Good luck!
Dr B
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I should add I am 30 years old. 5'4, 150 pounds
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