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"MAYBE" PCOS diagnosis?!?!

Hi I'm really confused and I need some advice as I feel so confused. I'm 19, normal-slim build, 8.5 stone and 5ft 3. I started my period when I was around 14, had two irregular periods, then went on the contraceptive pill. I was on the pill for about 6 months and had no bleeding in my breaks from the pill, then went onto the contraceptive injection (depo vera) for about a year. I then came off it as i thought it was strange that I wasn't having periods. It has now been 4 years since i've had any sort of period, and 2 years since I've been on any contraception. I have been with my boyfriend the entire time having regular intercourse and obviously haven't fallen pregnant as I don't have periods. I have had hormone blood tests, all of which came back normal. Was then sent for an ultrasound scan of my ovaries etc, and was told by the sonographer that I have a high number of follecules in my ovaries, but no predominant one that is releasing eggs. I have no increase in volume of my ovaries, and no cysts on them. I was also told that the lining of my uterus is very thin at 1.1mm. I was then refered to a gyno who put me on 10mg provera tablets for three months (1 a day for 10 days, then a 20 day break) to induce bleeding, which didn't work, just made my breasts extremely tender. On internal examination, all my reproductive organs are normal. I returned to the gyno today (saw a different doctor) who has now told me that due to my lack of periods and increased amount of follecules, it might be PCOS, but they're not going to do anything about it or any other tests until I want to fall pregnant. I have perfectly clear skin, am not at all overweight, and do not have any excess hair, so have no other symptoms. I've been left extremely disappointed with the "maybe" diagnosis, please can anyone give me some advice?!?!
1 Responses
603463 tn?1220630455
If you were my patient, I would advise you that the diagnosis of PCOS is probably correct.  PCOS is a catch-all term used to describe a variety of types of hormone imbalance which lead to irregular ovulation and cycles.

I am not surprised that the oral progesterone didn't work for you, since all of your data suggest that your estrogen level may be low.

If you were my patient, I would consider checking FSH, LH and estradiol levels. These tests would help to rule out premature ovarian failure, and might suggest hypothalamic amenorrhea instead of PCOS.

I would probably also suggest that you consider taking an oral contraceptive pill, or other form of supplementary estrogen/progesterone combination because of my concern about the effect of your (suspected) low estrogen level on your bones.  In any event I would definitely suggest supplementary Calcium and Vitamin D.
When you do desire a pregnancy, you may need to consider medication such as Clomid or Femara.
Hope this helps!
Dr B
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