FYI....just because there aren't any cysts or you do not have that many does not mean you do not have PCOS. I for one, do not have any cysts present at any of my ultrasounds (external and transvaginal) but I still do have PCOS. Please find a new doctor for a second opinon.
I'm not a doctor and am not pretending to be and you may have PCOS or you may not, I don't know but I can tell you that my husband was on three different types of blood pressure medication and then lost 40 some odd pounds. His blood pressure (thank God) has now gone down and he has stopped taking all of the medications. Of course the weight ties in with PCOS (especially around the mid-section) which of course leads to high blood pressure (of course a lot of other things do too). My OB/GYN prescribed Metformin and it has helped me a lot with the weight (that and a low calorie, sensible diet) and other issues. I was at 196 and now am down to 175 and hopefully will continue to lose weight. I'm 5 foot one if that helps to put things into perspective ! so 175 is still a lot for me even though I am "big built" I'll be happy at around 140 or so. My blood sugar and that low sugar feeling has also become less and less of a problem. From what I understand PCOS doesn't cause heart disease, diabetes, etc... but greatly increases your changes (complications, or as a result of, I suppose). Oh, just to let you know birth control pills help a LOT of women with PCOS but I just have problems taking them. they tend to make me an emotional basketcase and very depressed. If your doctor isn't making a lot of sense then I would seek a second opinion. Your doc. may be right or might be way off. I hope this helps!!!!!
It sounds like you have a lot going on. I have hirtuism also and problems with weight and acne and oily skin and the dark skin in areas where it shouldn't be, only one to two periods a year with a LOT of problems with them, etc... all the classic signs. I was diagnosed in my mid 20s with PCOS and at the time didn't have ANY cysts showing. My OB/GYN said they might not necessarily show or I guess even be present. Since then though I have developed several small cysts. If you are doubting your doctor or have a lot of things being left up in the air then maybe you should seek out a second opinion. Please don't get me wrong because I'm not a doctor, just a woman with PCOS and I'm not saying to ditch your doctor. But there's no harm in a second opinion or at least speaking with a medical professional. Also, just to let you know my hormones tests came back normal :) My OB/GYN said that I definitely have PCOS (and as I've stated the cysts developed later). It sounds like you should talk to another health care professional and get a second opinion. Good Luck!!!!!