WOMENS-HEALTH Messages for May, 2008: Re: PCOS: Hirsutism, deep voice, irregular periods etc...PCOS? Something else?

Re: PCOS: Hirsutism, deep voice, irregular periods etc...PCOS? Something else?

From: Walter Futterweit, MD, FACE,FACP (anonymous@obgyn.net)
Sun, 18 May 2008 13:21:33 -0500 (CDT)

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In reply to: elbasso: "PCOS: Hirsutism, deep voice, irregular periods etc...PCOS? Something else?"

At Tue, 13 May 2008, elbasso wrote: >
>Hi. I have been having long periods (not heavy) lasting about 7-10
>days, heavy for the first day or 2, but then mostly spotting. They are
>still fairly regular (28-30 days).
>
>My voice started becoming much deeper and more hoarse (noticeable to
>others) last September.
>
>I began getting darker, thicker facial hair on my chin and above my lip
>last fall also.
>
>I also believe my neck has become thicker, although I am not sure about
>that.
>
>I have periodic pelvic pain very low on the right side.
>
>I am using betamethasone (steroid ointment) and Estrace cream for lichen
>sclerosis. Could this possibly be causing all/some of these symptoms?
>
>Otherwise, I am wondering about PCOS, endometriosis, or maybe something
>else?

Dr.Futterweit: 1) There is the real possibility that topical steroids may be the reason. It absorbs easily and gives hirsutism, body changes, thicker neck and acanthosis nigicians, while insulin resistance can occur and sometimes may cause hoarseness. Has there been also increased wgt change? Plan: A fairly low AM cortisol and DHEAS may be helpful 2) Yes, PCOS is possible and the usual workup: T, Free Testosterone, insulin levels are useful, as well as a pelvic sonogram of the ovaries. 3) Rare causes may also include the possible devpt of an androgen-secreting tumor. T, free T is important. All need investigation. Have your physician also check clitoral size which may underscore the 3rd possibility. Best wishes. Dr. Futterweit

--
Walter Futterweit, MD, FACP, FACE
Clinical Professor of Medicine, Division of Endocrinology
Mount Sinai School of Medicine, New York, NY 10029
http://www.aacehost.com/pages/page.php?r=716

Next message: William F. von Almen, II, MD, FACOG: "Re: GYNECOLOGIC: bleeding during sex"
Previous message: cab: "Re: GYNECOLOGIC: bleeding during sex"
In reply to: elbasso: "PCOS: Hirsutism, deep voice, irregular periods etc...PCOS? Something else?"

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