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Treatment-BCP??
Does PCOS have to be treated with birth contol pills? What if I don't want to take birth control pills are there other options?
Your symptoms could point to PCOS indeed. Well hormones could show different things, but usually this combination of excessive androgens (and you're likely to have them if you experience hair loss, hirsutism and acne) and excessive insulin.
It does look like Cushings also, from what I know about it. Your symptoms could match indeed both but the causes are quite different. The main difference is with the cortisol levels, so if you test for that and are in order than you cannot have Cushings.
These 2 are similar indeed in their manifestations, but get the tests done and it has to come out clear so that you may know what course of treatment to take.
The fasting glucose test does not show if you have insulin resistance (which you probably do if you have either PCOS or Cushings). What I did was 1. insulin test (to see the levels of insulin in the blood, for insulin resistance they are often higher than normal). 2. OGTT (oral glucose tolerance test) - they give you a high dose of glucose and measure the glycemic level before and after the glucose drink. My OGTT was normal, so I am still able to manage glucose - but my insulin levels were very high, which shows that I am on the way to being insulin resistant.
Good luck and please investigate, either way, you have to get the tests done and have the treatment. Maybe you should test for Cushings first and, if it is ruled out, you should have those hormones done. And the best bet is to see an endocrinologist! They are the only doctors who really know about hormones, the gynecologists are less competent in this usually ( I went to 2 different ones first with my symptoms, no one suggested PCOS; they simply said have some cysts there and should get some BCP and that's that) my diagnosis was made by a competent endocrinologist, they will guide you and test you properly.
It does look like Cushings also, from what I know about it. Your symptoms could match indeed both but the causes are quite different. The main difference is with the cortisol levels, so if you test for that and are in order than you cannot have Cushings.
These 2 are similar indeed in their manifestations, but get the tests done and it has to come out clear so that you may know what course of treatment to take.
The fasting glucose test does not show if you have insulin resistance (which you probably do if you have either PCOS or Cushings). What I did was 1. insulin test (to see the levels of insulin in the blood, for insulin resistance they are often higher than normal). 2. OGTT (oral glucose tolerance test) - they give you a high dose of glucose and measure the glycemic level before and after the glucose drink. My OGTT was normal, so I am still able to manage glucose - but my insulin levels were very high, which shows that I am on the way to being insulin resistant.
Good luck and please investigate, either way, you have to get the tests done and have the treatment. Maybe you should test for Cushings first and, if it is ruled out, you should have those hormones done. And the best bet is to see an endocrinologist! They are the only doctors who really know about hormones, the gynecologists are less competent in this usually ( I went to 2 different ones first with my symptoms, no one suggested PCOS; they simply said have some cysts there and should get some BCP and that's that) my diagnosis was made by a competent endocrinologist, they will guide you and test you properly.
These are my symptoms:
Excessive hair growth (my face especially the upper lip, my breasts and abdomen, and upper thighs)
Hair loss on my scalp, anytime I run my fingers through my hair I pull stands of hair out
Weight gain (about 40 pounds in 6 months) however the weight is only in my abdomen (my wrists are still freakishly small) and I'm probably even more active than I was before.
Fatigue (I try to practice good sleep hygiene and always get at least 8 hours of sleep) and not just tired mentally physically tired. My sleep cycle is also all messed up I tend to be extremely tired between 4-9pm and most awake 11pm-2am. I usually go to bed around 2:30am and wake up at 11am.
Stretch marks (purple and white across my abdomen)
Acne, I never had really bad acne, even as a high schooler, I only had mild breakouts, now I have bad breakouts on my face and going down onto my neck
Like I've said my dr said she couldn't give me a dx that she was 100% sure of... but she felt strongly that I had the PCOS.
I feel like the PCOS describes most of my symptoms... but not all and some would be a stretch. From research that I have been doing I have found that cushing's syndrome better explains all of my symptoms. From the research I've done I've also found that PCOS and cushing's are extremly alike in presentation but you can't test for PCOS w/o considering and testing for cushings especially if symptoms are favoring cushings... a doctor friend of mine recommended that I find a doctor who will test for cushings and he told me not to ask about cushings when I saw the gyn (who said it was most likely PCOS) but to talk to my primary... which I am in the process of doing, so this whole thing is a big mess.
I realize that I could have PCOS and that then I guess I would most likely have to take bcp... but until we can be sure it's not something else... idk
The problem with hormones is that there are so many things that can cause hormones to go out of wack... once one goes crazy it's not hard for others to follow suit.... which COULD hide a different issue, espeically if someone would be dx with PCOS and treated to 'fix' the hormones they tested... and they may just end up covering up a different problem.
I'm not sure anymore.... I just think I'm not going to settle for what I've been given thus far.
Excessive hair growth (my face especially the upper lip, my breasts and abdomen, and upper thighs)
Hair loss on my scalp, anytime I run my fingers through my hair I pull stands of hair out
Weight gain (about 40 pounds in 6 months) however the weight is only in my abdomen (my wrists are still freakishly small) and I'm probably even more active than I was before.
Fatigue (I try to practice good sleep hygiene and always get at least 8 hours of sleep) and not just tired mentally physically tired. My sleep cycle is also all messed up I tend to be extremely tired between 4-9pm and most awake 11pm-2am. I usually go to bed around 2:30am and wake up at 11am.
Stretch marks (purple and white across my abdomen)
Acne, I never had really bad acne, even as a high schooler, I only had mild breakouts, now I have bad breakouts on my face and going down onto my neck
Like I've said my dr said she couldn't give me a dx that she was 100% sure of... but she felt strongly that I had the PCOS.
I feel like the PCOS describes most of my symptoms... but not all and some would be a stretch. From research that I have been doing I have found that cushing's syndrome better explains all of my symptoms. From the research I've done I've also found that PCOS and cushing's are extremly alike in presentation but you can't test for PCOS w/o considering and testing for cushings especially if symptoms are favoring cushings... a doctor friend of mine recommended that I find a doctor who will test for cushings and he told me not to ask about cushings when I saw the gyn (who said it was most likely PCOS) but to talk to my primary... which I am in the process of doing, so this whole thing is a big mess.
I realize that I could have PCOS and that then I guess I would most likely have to take bcp... but until we can be sure it's not something else... idk
The problem with hormones is that there are so many things that can cause hormones to go out of wack... once one goes crazy it's not hard for others to follow suit.... which COULD hide a different issue, espeically if someone would be dx with PCOS and treated to 'fix' the hormones they tested... and they may just end up covering up a different problem.
I'm not sure anymore.... I just think I'm not going to settle for what I've been given thus far.
Also, my doc. didn't have to rule out anything else first. She also performed the thyroid tests, hypothyroidism can have some similar manifestations (Women with PCOS are moreover at high risk for hypothyroidism, the hormones are all related). But the tests were fine for the thyroid and not so great for androgens and insulin. But I do believe she suspected the moment I described my symptoms that it must be PCOS. And unfortunately, I have no doubt she was right. I think it is highly unlikely that you have it unless the tests for insulin and androgens/ or LH and FSH show something. This is the very definition of PCOS.
While the symptoms and the tests will definitely be very different for different women, there are some guidelines, it seems rather absurd to say that you have to rule out everything else to make a diagnosis. It is not such a mysterious condition after all. It's true that some women do not have the cysts, but what is actually important is the hormones. The cysts come and go, so they may not be there with the ultrasound. The hormones will always be out of balance, esp. without treatment.
Hey again, I don't know why your dr thinks it so difficult to diagnose it. I guess there are exceptional and atypical cases, but otherwise it should be pretty clear. I was diagnosed based on the following: polycystic ovaries, hairloss (which is the symptom that got me to the endocrinologist in the first place), excessive amounts of DHEA in the blood and excessive insulin. There a lot of hormonal tests that have to be done in order to diagnose it. Usually it is either testosterone or the DHEA that come out abnormal (the androgens), and sometimes LH and FSH can be abnormal too. The tests have to be performed, if I recall right, in the first few days after the menstruation stops, otherwise they are not as relevant. Each of these hormones will be found in a particular amount according to the specific period of the menstruation cycle.
So did you have any of these done? Why does your doc suspect PCOS anyway? Have you been tested for the amount of insulin in the blood?
So did you have any of these done? Why does your doc suspect PCOS anyway? Have you been tested for the amount of insulin in the blood?
My dr told me that there really isn't much they can do to test for it. She said they could do an ultrasound to check for cysts but that people can have PCOS w/o any cysts and that people can have cysts w/o PCOS... she said that there wasn't any test that could confirm or dismiss PCOS as a dx.
My periods are very regular... and I rarely miss a period the only time I have was when I was under a HUGE amount of stress (I even had ketones in my urine then), but once the stress was gone everything returned to normal.
From the research I've been doing it seems like diagnosing PCOS can be done by ruling out other things can cause similair symptoms... how were people here dx? did they rule out other stuff first?
My periods are very regular... and I rarely miss a period the only time I have was when I was under a HUGE amount of stress (I even had ketones in my urine then), but once the stress was gone everything returned to normal.
From the research I've been doing it seems like diagnosing PCOS can be done by ruling out other things can cause similair symptoms... how were people here dx? did they rule out other stuff first?
I used to get all my periods, I never missed one. It depends on what you mean by regular, it did come every month for me, but it was surely not a perfect cycle, it would be late 3-5 days or come earlier 2-3 days.
It's a different thing if you don't know if you have PCOS, have you done the necessary tests? And you have to understand, if you do have it, it is not about the period per se, but the hormones that regulate it. If those are not in the proper amounts you are at risk. I think the first thing to do is to check if you have PCOS and go from there. As far as I know, the risk is there for anyone that has it.
It's a different thing if you don't know if you have PCOS, have you done the necessary tests? And you have to understand, if you do have it, it is not about the period per se, but the hormones that regulate it. If those are not in the proper amounts you are at risk. I think the first thing to do is to check if you have PCOS and go from there. As far as I know, the risk is there for anyone that has it.
My doctor knew from the start that I didn't want to take bcp... but she tried to convince me to take them... but her logic didn't make sense.
She told me basically the same thing you guys have said, that I need to have my period otherwise it's not healthy... she said that you need to have at least every 3 months, and that bcp could help do that. However... I still get my period... my period is very regular so the bcp isn't that necessary... and she agreed with me she mentioned metformin... but wants me to be tested for insulin resistance before starting that.
My PCP doesn't think that I have PCOS because I still do get my periods... does anyone on here still get their periods regularly w/o bcp??
She told me basically the same thing you guys have said, that I need to have my period otherwise it's not healthy... she said that you need to have at least every 3 months, and that bcp could help do that. However... I still get my period... my period is very regular so the bcp isn't that necessary... and she agreed with me she mentioned metformin... but wants me to be tested for insulin resistance before starting that.
My PCP doesn't think that I have PCOS because I still do get my periods... does anyone on here still get their periods regularly w/o bcp??
Yes I agree with luisa24. My doctor has always warned me, in my case if I didn't lose weight then i have a higher risk to develope endometrine cancer. Birth control pills also help to reudce in time the number of cysts 1 could develope. It also down grades the risk for endo cancer and ovarian cancer.
Women with PCOS are at a high risk for endometrial cancer, and, the right type of BCP help reduce the risk quite a lot (50% is what I have read) - and this is mainly due to the combination of progesteron and estrogen. None of the other treatments help in this respect. Just talk to your doctor about all the risks and possibilities. There are a lot of different opinions out there. When my doc prescrived BCP I told him I don't want them because I'm afraid of the consequences (breast cancer mainly) - her reaction was, if I don't do it the risk for endometrial or ovarian cancer will be far greater.
So there is a question of symptoms ( I take BCP to manage my symptoms as well) but also one of possibly preventing some risks.
So there is a question of symptoms ( I take BCP to manage my symptoms as well) but also one of possibly preventing some risks.
Are you taking metformin? Metformin is known to help with the symptoms of pcos. It also helps with weight loss (if overweight) and in time can improve your cycles. How old are you? Birth control pills just help matain a normal cycle each month. I take Yasmin and they are a very low dose form of pills. I've been on them close to 2 years and have never had a problem with side affects either. If you have irregular bleeding each month, then bcp will help contol that. Other then that I don't know what else you would take to help with the symptoms.
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