PCOS Messages for August, 2003: Re: Any *lean* women taking Metformin?

Re: Any lean women taking Metformin?

From: anonymous (anonymous@obgyn.net)
Fri, 15 Aug 2003 14:11:31 -0500 (CDT)

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At Fri, 15 Aug 2003, anonymous wrote: >
>>Hope this helps.
>
>Thank you very much for your quick reply. I always had my periods,
>almost never missed one, unless I was really stressed. And that only
>happened twice. My cycles were always long though ~4.5 weeks. 1.5
>years ago they started to come 3-5-3-5-3-5 weeks of intervals. I was in
>a lot of stress (preparing for my PhD defence) I thought it was because
>of that. But they continued like that and all of a sudden they stopped,
>and I kind a spotted for 3 months. Then I went to see a gyno and my US
>showed polycystic ovaries. I wanted to have children and am alredy 33
>so they started Clomid immediately, and since then my body never is left
>in itself, only this month and i had very light period, almost spotting.
>Yes, I eat always small, since my childhood I was always very very thin,
>I try to sport whenever it is possible and I am concerned about my
>weight. My BMI is ~18.5, it was even less before I quit smoking (but I
>was at least having my periods back than!).
>Apart from the US I don't have any other signs of PCOS. My DHEAs is a
>little high but it is still in the normal range.
>Last few months during Clomid I even gained 3-4 kilos but it didn't help
>with my ovulation at all. It only put me in a lot of extra stress.
>Since my diagnosis I hate my body, I KNOW that this is not my fault, but
>I don't FEEL that way. Sorry, this is turning into a venting mail.
>I am thinking: since gaining weight did not help me maybe loosing a
>little and going back to my normal! (smoking) weight could be the
>solution. May be being underweight is a good thing for PCOSers. What
>would you think? About the injectables. Do they make you as moody as
>Clomid, or may be even more. I was really depressed when I was taking
>Clomid, will it be more with the injectables?
>One last question, how do they diagnose hypothalamic amonerrhea?
>
>I am really greatful to you, and again thank you very much for your
>help. This means a lot to me.

You are not alone in your frustration over your body. I think it would definitely help if you had some answers which you do not at this point. I will first say that you probably should not try to lose any weight at this point. For women with PCOS who are overweight, they need to lose weight to help the insulin resistance but if you truly have a BMI around 18.5, that is probably not necessary. In terms of your diagnosis, you can have polycystic ovaries without having PCOS, and vice versa. The fact that you had regular periods at one point in your life and have not other symptoms makes the diagnosis a little questionable but not impossible. Have you had a period with Clomid? How long has all this been going on (when did you quit smoking?)?Did you ever have an US while on Clomid to see if any follicles are developing (ovulating)and what your uterine lining looks like? If you are currently being treated by an OB/GYN, you might want to see an endocrinologist for a more thorough workup. Again, if you have PCOS you might need metformin to help you ovulate but if you do not have PCOS then you need a diagnosis. Stress can certainly cause our menstrual cycles to go out of whack but there may be something else that is doing it as well that can be treated.

In terms of the injectables, if you have to go that route, I found that I had less symptoms than with Clomid. Less moody. But again more hyperstimulation.

Hypothalamic amenorrhea is usually diagnosed by blood tests which show a low estrogen level and low FSH and LH. Again there are many causes including low body fat, anorexia, excessive exercise, stress, and also pituitary problems. When was the last time you had a full panel of labs done, including prolactin, estrogen, testosterone, thyroid, FSH, LH, etc?

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