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Re: Hi, I'm new hereFrom: anonymous (anonymous@obgyn.net)Sat, 24 Feb 2001 02:45:02 -0600 (CST)
Hi Jackie and Welcome, It is possibly known that PCOS could be hereditory so it could of been passed down by your mother. There are numerous tests the Doctor could do to establish whether you have PCOS. Just remember that PCOS is a complex condition and women can present with different symptoms. YOu don't have to have all the symptoms and all abnormal blood tests to have PCOS. The doctor could do the following blood tests- FSH and LH (Follicle Stimulating Hormone) and (Lutenizing Hormone). The first is the hormone which assists with the maturation and development of the eggs at the begginning of the cycle. The LH is responsible for the release of the egg. Prior to ovulation about 24-36 hours beforehand, oestrogen causes a surge of LH so the levels are raised which causes an egg to be released from the ovary. In PCOS these hormones can be effected and it is quite characteristic to have continued elevated LH in the blood which prevents the release of the egg. The blood tests should be taken at the right time of the cycle. Between 1-5 days of the beginning of menses to ensure the correct results. Normally the FSH will be raised since it is developming eggs compared to the LH which should be lower. IN PCOS sometimes both hormone levels will not be within normal range with FSH being lower and LH being higher. It is healthy to have raised LH midcycle to stimulate ovulation but not at the beginning of the cycle. This can in turn cause absence of menses or/and irregular periods since the control systems and responses in the brain and organs will not respond or can't respond to level changes. Prolactin- Because PCOS is a hormonal and endocrine condition then it can effect many systems that produce and control hormone release thus levels. Prolactin can be raised with PCOS and is controlled by the Pitiutory Gland. Raised levels can prevent ovulation so an egg won't be released and causes anovulatory cycles. This in turn can cause irregular periods or lack of them. Coupled with irregularties of FSH and LH. Progesterone- This is a heat producing hormone and is released and has raised levels after ovulation. For women that undertake basal body temperatures whether that be for natural birth control or when trying to concieve, it is characteristic to have lower temps before ovulation and a temp spike post ovulation.Temps will remain high until menses when it will drop. Raised progesterone will only occur if ovulation has taken place since the follicle left behind in the ovary once the egg has been released called the corpus Luteam will produce Progesterone and allow continue higher levels unless conception has not occurred. With PCOS, since ovulation may never happen or fairly rarely, then these levels are normally low. To have an accurate results, these bloods should be taken 7 days post ovulation. Oestrogen and Testosterone- Testsoeterone is the 'male hormone' but in women there are small amounts anyway. In PCOS it can be common for Testosterone to be raised thus upsets the balance of the menstrual cycle- prevents ovulation, irregular periods and increase body hair particularly on the face. Oesterogen in these cases will be more depleted possibly, so again will upset the menstrual cycle. The reason these hormones are produced is from the adrenal glands which produce 'aldosterone' (Sex hormones). Thyroid Function Test- common period irregularties along with weight gain, etc can also be caused by thyroid disorders so it probably will be standard practice to get this blood test done since these symptoms do not necessarily mean that it is PCOS. Fasting Glucose levels and Insulin Resistant- Alot of PCOS sufferers may be insulin resistant so Fasting sugar levels could be monitored along with insulin resistant tests. This can effect menstrual cycles and hormone levels which in turn effects the metabolism of the body systems. Weight gain is a common indicator of PCOS so these levels should be checked. Cholesterol levels- Have been known for PCOS have raised levels at times and again since the metabolism is effected, thus effects these levels as well. Pelvic Scan- Can be performed to see if there are cysts on the ovaries. This is a commom characteristic of PCOS but the cysts are not the primary cause of PCOS, they are the secondary cause since the cysts will be formed due to other factors. However equally, you don't have to have cysts to have PCOS either. The cysts form because maturation and release of eggs have not been maintained so cycts develop on the ovaries. To summerise then- Blood tests: 1)FSH and LH (day 1-5 of cycle) 2)prolactin (can be taken any time of cycle) 3)progesterone (7 days post ovulation) 4)Oesterogen (possibly midcycle) 5)Testosterone (can do the test the same as above to have a ratio) 6) Thyroid Function test 7)Fasting blood glucose levels - could be monitored over a period of time 8) Insulin resistant test (can be a random test) 9)Cholesterol (random test) Examinations- Pelvic Scan Common Signs and symptoms- 1) cystic ovaries (abnromal FSH and LH levels) 2) Increase in hair growth particularly facial can be severe (due to raise testosterone) 3)Weight gain-obsesity (Effected metablosim by insulin resistance, glucose levels) 4)Lack of periods, no periods, irregualr cycles (Raised prolactin, altered FSH and LH levels. high Testoseteone levels, depleted Oestrogen) 4)Raised fasting glucose levels- insulin resistant Treatment_ BCP for women who are not trying to concieve. Will maintain regular cycles but period will only be withdrawal bleed not true period. Can mask symptoms but can regularate cycle whilst on the medication. Will prevent ovulation thus preventing formation of cysts. Clomid- to stimulate ovulation tend to only be used for part of fertility treatment. Low Carb diet- to assist with weight loss for obseity and reduce sugar intake for insulin resistance. Alo can help regulate cycles. metformin- medication can be given for insulin resistant conditions, help regulate insulin levels, absorption and metabolism of appropriate glucose and insulin. Can regulate cycles, induce ovulation. Spironlactone- an aldosteone medication, can assist with reduction of excessive hair and fluid retention. Aldactone- can be prescribed to reduce testosterone levels, again may help regulate menstrual cycle and reduce excessive hair. Thyroxine- can be given if thyroid function test indicate abnormality. Ovarian Drilling- tSurgical procedure o reduce the cysts, can assist with ovulation and help women ttc. You can maybe chart your temps to establish a pattern to see whether you ovulate or not. At least there is something you can give to your doctor and establish a form of treatment plan if required. Temps need to be taken before rising from bed in the morning and preferably around the same time each day. Hope this helps and good luck
At Fri, 23 Feb 2001, Jackie wrote:
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