What is wrong with me?

[FeelingBlu]

Hi All,

I'm 27. Currently 205 lbs. Been on Metformin for a year, no other meds.

- had been dealing with facial hair, thicker than average hair on my body and weight issues since I was 12-13.

- 6 yrs ago I did permanent hair removal on my beard and mustache area for almost 2 years with absolutely no results.

-got married and immediately got pregnant so I didn't worry about these issues for years.

-my symptoms have worsened more and more. Now I have to remove my facial hair twice a day.

The blood test result showed high testosterone so I was referred to an endocrinologist. The endo said he assumes it is PCOS, they did blood tests again, nothing outstanding, just mildly elevated testosterone then I was sent to a GYN to see if I have polycystic ovaries which I do have. So I was diagnosed with PCOS at the age of 26 after many years of not knowing what is causing my excess hair growth, hair loss on my scalp, inability to lose weight, very quick weight gain.

I just moved to a new place and my new endo did even more thorough blood testing and sent me to a new GYN. The GYN saw the polycystic ovaries and when I went back to my endo, she said my blood test results are perfect, I have no thyroid problem, no hormonal imbalances, both my free testosterone index and regular testosterone are in normal ranges according to this new result. So she talked to my GYN on the phone and she said she cannot confirm my former diagnosis of PCOS with completely normal testosterone levels and ovulation present.

My periods had been completely normal up to the age of 24. I have never taken BC pills or anything else. Since then, they haven't been that regular and my periods often start with brown discharge for the first 2 days. She said if I had PCOS, my periods would have never been regular but that's not the case and I even have a 5-year-old child. Therefore, she said I have no endocrine issue but MUST keep taking Metformin.

My question is: how can a woman who has to remove facial hair twice a day have normal testosterone levels? I mean this is something you see on your face, it's not a delusion. I have a beard basically. My new endo said fat people store more testosterone, I would not have this if I was thin. But I said I was just mildly overweight as a teen, young adult and I had facial hair issues already. I did permanent hair removal for 2 years, if I didn't have any medical problems, it would have worked, wouldn't it? When I pointed out that my androsterone level is high, she said that's just because obese people often have that. She said I probably inherited this hairiness from someone in the family (?) and I gain weight easily because that's how my body is.

I am confused as to what to think now since she said I have to keep taking Metformin. If she thinks I have no PCOS, why offer Metformin? I am so tired of going to medical appointments. What should I do now? I want to get rid of this facial hair and the excess weight I have even though I eat so clean.

[FeelingBlu]

Thank you for your comment! I agree with you, exercise is also important. She said I need to keep taking Met because my testosterone was high last year but not high now and the only difference is that I have been on Met for a year so she thinks Met is helping me with the testosterone but I told her I don't think so for 4 reasons: I had facial hair when I was not fat; when I did permanent hair removal, I was not fat yet it didn't work; Met is not for testosterone treatment; and if she thinks I have no PCOS, why would Met make a difference for me in this sense? My weight did not significantly decrease between the 2 tests. I was 219 lbs last year and 215 lbs this year at the test. I'm only 5'3" so that's still obese. I told her I am happy if I really have no PCOS but then there must be a solution/explanation for my medical issues. These got so bad in the past 2-3 years that my life is in ruins, it's not like going to doctors is a pastime activity for me, I just want a remedy. I'm young but I look and feel old and ill. So her explanation was it's all "genetic" with me. So having a beard even as a teen, young adult is genetic, nothing more? No woman in my family had facial hair at this age for sure then she said certain women with Italian and other Southern European background have this naturally but that's not even close to my ethnic background. I have cysts on my ovaries too. What's the explanation for that? This whole thing doesn't make sense to me. I can't afford going back to her anyway. I'm tired of the whole thing.

[thatquietgirl]

If she's so convinced the androsterone levels are high and that you may be storing testosterone due to your weight, I'd try weight loss.  Eating clean will not be enough on its own.  You'll have to incorporate daily exercise and portion control.  Once you've lost weight (let's say 10-15 pounds), ask for blood tests again.  If the androsterone levels are still high, ask her to explain it because unless you're not very tall, that 10-15 pounds should bring you within high but not obese BFP levels.

It is very strange to me that you do not have high testosterone levels showing in blood tests as usually the excess body hair and such indicates that testosterone levels are high.

Keep your chin up!  You will get to the bottom of this over time.

I would personally take it as my next step to call her and ask why she says you "must" keep taking the Metformin.  If she can't offer an explanation, tell her she needs to instruct you how to stop using Metformin safely as you do not want to take something that clearly is not medically necessary due to her lack of explanation.  If she can offer an explanation, then obviously, go with what she says, but you as the patient deserve an explanation for any medication that a doctor places you on.