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I think I have a hormonal imbalance, what should my next step be?
Hi! TY for reading.

Here are my stats: I'm a 27-year-old female and in great health. I'm 5'5'' and 125 pounds. I eat 95% clean (lean protein, veggies, healthy fats, and complex carbs) and do strenuous workouts 5-6 days a week. When I was 20, I had an malignant ovarian tumor called a dysgermenoma which was removed with surgery. No chemo or radiation was needed. I have half of a remaining ovary now.

I was on birth control from the time I was 16 to 18 and again from 19-24. For the past three years, since getting off birth control, I have had bleeding with intercourse. My obgyn checked for cancer, pollups and cysts with no results. She assured me it was fine. However, in the last year, I have had more consistent bleeding with intercourse (pretty much every time), but in the last year, I have had bleeding or red discharge from the vaginal area with my bowel movements. This is less frequent, but when it happens, there is a "tugging" feeling inside my lower abdomen. It is also somewhat uncomfortable to have intercourse. I do have regular, but very heavy and painful periods.

Other symptoms in the last year are a receding hairline (very noticeable to me), significant increase in whitehead acne, night sweats (every night for the past two weeks), and this month, I've had heart palpitations. In the last year, I have upped my workouts and moved to a more high protein, low carb diet. I read about possibilities of my diet causing some of this but from my research it feels like it is hormonal. I went to see a different obgyn a few months ago and she ran a t-vag xray or something which didn't show anything and she also tested my hormone levels which were normal. Is it impossible for me to have a hormone imbalance or should I get tested again?

From what I've read, I feel like early menopause could be possible, endometriosis, pcos, or maybe complications with scar tissue? Fertility is also a priority. Should I see an endocrinologist?  
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1 Answers
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603463 tn?1220630455
If you were my patient, I would encourage you to see a reproductive endocrinologist.  I would order the following blood tests:  FSH/LH, beta hcg
cd 21 progesterone, DHEAS, 17 hydroxyprogesterone,testosterone level, TSH and prolactin.
I would also consider doing an Antimullerian hormone level, Ca 125 (looking for endometriosis).  Hair loss is most commonly hereditary, but could be related to either ovarian or adrenal function.  PCOS is unlikely since you have regular periods, but Premature ovarian failure would not be out of the question.
Pelvic adhesions and/or endometriosis could be contributing to your discomfort.
There are so many things to consider.  An RE would probably be a good idea--also since you may need assistance conceiving when the time comes.
Hope this helps!
Dr B
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