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Re: PCOS- effect of BTL or perimenopauseFrom: William F. von Almen, II, MD, FACOG (anonymous@obgyn.net)Sun, 12 Nov 2000 23:22:09 -0600 (CST)
At Sun, 12 Nov 2000, Nancy wrote: > >At Sun, 12 Nov 2000, William F. von Almen, II, MD, FACOG wrote: >> >>At Sun, 12 Nov 2000, Nancy wrote: >>> >>>At Sat, 11 Nov 2000, Harvey S. Marchbein, M.D. wrote: >>>> >>>>Now that you've shared the enormous amount of data from the previous >>>>post, you may indeed have PCO with normal ovaries as some women do have. >>>>I agrtee with Dr. Shanahan about the potentila for Glucophage. Since >>>>you've never had blood tests, FSH & LH may be helpful. There are some >>>>women with insulin resistance and hyperandrogenism who have normal >>>>FSH/LH as well. >>>> >>>>HSM >>>> >>>#1- Would AVANDIA be as good as Glucophage or do they do different >>>things? My blood sugar is low at times,especially after I eat. >>>#2- Seeing my Family Practice doctor this week. It will be day 7 of my >>>cycle. Can I have labs that day or should they be timed differently. On >>>another board, an M.D. suggested I should have a midcycle estradiol >>>level to assess for decreasing levels- possible perimenopause. >>>#3- If I have high levels of estrogens or androgens, could this explain >>>why my thyroid tests always appear normal even though I have 90% of the >>>symptoms of hypothyroidism (plus a nodule)? I read that high levels of >>>estrogen could affect thyroid binding globulin. >>>>At Sat, 11 Nov 2000, Nancy wrote: >>>>> >>>>>At Sat, 11 Nov 2000, Harvey S. Marchbein, M.D. wrote: >>>>>> >>>>>>PCO, if it's there, is usually picked up way before tubal ligations or >>>>>>perimenopause, so the question is unable to be answered unless there >>>>>>were problems before that were overlooked. >>>>>> >>>>>>When monoapuse is complete, PCO does'nt exist but the precursors may >>>>>>still be there - insulin insensivity and hyperandrogenism. The course >>>>>>after menopause is variable with respect to lipids, glucose and weight. >>>>>> >>>>>>Hope this helps and write back anytime for more information. >>>>>> >>>>>>HSM >>>>> >>>>>COULD YOU ALSO SEE MY PREVIOUS POST WRITTEN NOV 10TH: >>>>>"LONGSTANDING UNDIAGNOSED PROBLEM- PCOS? HYPOTHYROIDISM? >>>>>I'm just trying to make sure I ask for the right tests at the right time >>>>>etc. I too have disregarded PCOS as a possiblity in the past because >>>>>multiple doctors have had opportunity to figure this out over the years >>>>>but have not come to any conclusion. However, I've also been treated >>>>>with BCP, danazol and synarel, thinking it was an endometriosis type >>>>>thing although the timing certainly was bizarre. Then had 3 pregnancies >>>>>in three years and later had my BTL, so I'm thinking all of these things >>>>>could have controlled or masked some of the signs and symptoms, >>>>>particulary if I had the more atypical type without the PCO appearance >>>>>and with maybe a milder androgenic effect. Details in other post. >>>>>Thanks. Have several appts coming up next week and want to finally get >>>>>answers. I've been having problems for 25 years now and have never had >>>>>any female/male hormone levels done. Oh yes, one thing not mentioned in >>>>>the other post is that I tried very hard to nurse my first 2 34 week >>>>>babies with no success. Even with round the clock ,double electric >>>>>breast pump every 3 hours, plus allowing the baby to nurse first each >>>>>time, I just never made more than about 2-3 oz of milk per DAY. >>>>>Lactation consultant could not see a problem with how either baby >>>>>nursed. Thought this might also have a hormonal clue. >>>>> >>>>>>At Sat, 11 Nov 2000, Nancy wrote: >>>>>>> >>>>>>>Would hormonal changes that occur with post tubal ligation syndrome (if >>>>>>>it truly exists) or with perimenopause, make it difficult to diagnose >>>>>>>PCOS? >>>>>>>Also, when menopause is complete, how do symptoms of PCOS change? Do >>>>>>>lipid or glucose abnormalities improve or worsen? Does weight change? >>>>>>> >>>>>>>-- >>>>>>>Nancy >>>>>>> >>>>>>-- >>>>>>Harvey S. Marchbein, M.D. FACOG, FACS >>>>>>Great Neck, New York >>>>>> >>>>>>**Note: Opinions expressed here are for educational purposes only >>>>>>and, as such, do not constitute a physician-patient relationship. >>>>>>This information is not intended to supplant the need for you to >>>>>>consult with your physician prior to choosing therapeutic options >>>>>>and/or interventions. >>>>>> >>>>>>**Private emails cannot be entertained due to time constraints, >>>>>>consequently no private emails will receive a response. >>>>>> >>>>>>**Thank you for your understanding ;-) >>>>>> >>>>>>Please be aware that all e-mail on this forum is archived and can be viewed at >>>>>>http://forums.obgyn.net/womens-health, >>>>>>http://forums.obgyn.net/pregnancy-birth or >>>>>>http://forums.obgyn.net/young-women >>>>>>and is accessible to anybody on the >>>>>>internet including internet search engines. This should be taken into >>>>>>consideration before sending postings of a personal or confidential nature. >>>>>> >>>>>-- >>>>>Nancy >>>>> >>>>-- >>>>Harvey S. Marchbein, M.D. FACOG, FACS >>>>Great Neck, New York >>>> >>>>**Note: Opinions expressed here are for educational purposes only >>>>and, as such, do not constitute a physician-patient relationship. >>>>This information is not intended to supplant the need for you to >>>>consult with your physician prior to choosing therapeutic options >>>>and/or interventions. >>>> >>>>**Private emails cannot be entertained due to time constraints, >>>>consequently no private emails will receive a response. >>>> >>>>**Thank you for your understanding ;-) >>>> >>>>Please be aware that all e-mail on this forum is archived and can be viewed at >>>>http://forums.obgyn.net/womens-health, >>>>http://forums.obgyn.net/pregnancy-birth or >>>>http://forums.obgyn.net/young-women >>>>and is accessible to anybody on the >>>>internet including internet search engines. This should be taken into >>>>consideration before sending postings of a personal or confidential nature. >>>> >>>-- >>>Nancy >>> >>Nancy >> >>Not sure about avandia vs glucophage. >>Day 7 is not a good day for any thing you need. You probably need >>fsh/lh, estradiol and progesterone all done after ovulation (probably >>about day 7). Hope this helps. >> >>--I'm sorry, but I'm not sure what you mean. Do you mean 7 days after ovulation (around day 21) ? >>William F. von Almen, II, MD, FACOG >>Editorial Advisor-Pregnancy and Birth >>Private Practice >>New Orleans, La. >> >>*Please understand I can not respond to private emails. >> >>*These comments are for educational purposes only. They are >>not meant to take the place of an examination by a qualified >>health care provider. They are not intended to be the start >>of a physician-patient relationship. >> >-- >Nancy > nancy Yes, day 7after ovulation, or day 21 if it is a 28 day cycle. Hope this helps.
-- William F. von Almen, II, MD, FACOG Editorial Advisor-Pregnancy and Birth Private Practice New Orleans, La.
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