Thank you for your query at DoctorSpring.com
From the information you have provided, you do seem to have anovulatory cycle, hence the response to progesterone.
The excess testosterone could be just due to excess weight, but certain conditions need to be excluded in this setting.
You need endocrinology consultation to exclude Cushing's syndrome (excess cortisol), excess 17 OH Progesterone (late onset CAH) and of course PCOD. Ultrasound will be helpful in PCOD.
Hypothyroidism seems to have been ruled out.
Please let me know if you have further queries,
Patient replied :
Would you be able to provide me symptoms of these condition and perhaps a brief summary of each?
The symptoms are as following :
Cushing's - Weight gain, round plethoric face, easy bruising, muscle weakness, pains, excess body hair, acne, purple striae over abdomen, buffalo hump near the neck.
Late onset CAH - similar history in a sibling, acne, excess body hair, irregular menses/no menses.
PCOS- simialr to Late onset CAH, excess weight gain, family history of type 2 diabetes, delayed periods.
These are the main presenting symptoms.
Sometimes all the sympoms classically won't be present.
Hence it's better you get yourself evaluated.
Patient replied :
And how many symptoms are generally presented when ssomeone is suspected of having any of these conditions? I've heard about PCOS but not about Cushings or CAH. Further, when you say round plethoric face, muscle weakness, and buffalo hump what do you mean? Also, how much body hair defines excess body hair? I aso see that pain is one of the symptoms of one fo the conditions you outlined? What kind of pain and where...like generalized pain or pain in a specific area?
There can be any number of symptoms.
Plethoric face is flushed face ( where the face appears pink due to increased blood supply ), buffalo hump is fat collected on upper back under the nape of the neck.
Muscle weakness and pain usually affects the muscles of thighs, arms and hips.
Body hair is more than normal, on face, chest, back and abdomen. It's darker than usual and thicker. There will be excessive hair in the armpits/ limbs.
Let me know if i can help you further,