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Symptoms of PCOS with missed periods.

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Hi, I'm 20 years old patientold I went to the gyn last week because I hadn't gotten my period since December, and it's now August. I have been feeling very tired all the time and a little depressed, have been gaining weight rapidly (even though I eat well and exercise regularly) and struggle with acne. I have also struggled with anxiety. I'm currently taking Singulair for allergies and Aldactone for the acne. 

I was on birth control since freshman year of HS to treat the acne, and came off in December to try to lose some weight. I explained my symptoms and my gyn thought it was most likely PCOS, and I had blood drawn. I have no family history of PCOS, although my aunt has endometriosis. After the visit my gyn put me on Progesterone for five days and then when I start my period I will also start up the birth control again. I was sure, based on my symptoms, that I had PCOS. 

(Side note: I always thought there was something wrong, since the age of 10 when I started gaining weight abnormally, and ever since it hasn't come off no matter what I try. Currently I'm only 5'0 but weigh about 155, I've gained about 10 lbs since going off the birth control even though nothing else has changed. I was also hospitalized earlier this year for a stomach flu they thought could have been appendicitis, it ended up not being appendicitis, but they did tell me that I had a fatty liver, which surprised me because even though I'm overweight I would consider myself pretty healthy.) 

However, I just got the blood results back online and was surprised to find that the results were normal for everything (Testosterone, DHEA etc.) except Estradiol. The Estradiol level was 12.2. 

Could I still have PCOS? Or could it be something else? I was honestly relieved when I heard it could be PCOS because it meant that all of my symptoms meant something, but now I'm questioning it, and the gyn is closed tomorrow so I can't call. I'm just very frustrated, and would like another opinion. Thank you.

Category: OBGYN

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Category: Infertility Specialist
 27 Doctors Online

Thanks for writing to with your health concern.
Based on your clinical picture, I would say that you have PCOS .
However, I need to look at the blood work that has been done so far.
To diagnose PCOS, there is a battery of tests which are carried out.
Can you please upload the tests already done, so that I can guide you further ?
Looking forward to hearing from you.
Take care.

Patient replied :

Here are my blood test results, these are the only tests I have so far:
They were all normal except Estradiol.

Testosterone, Serum 10
Free Testosterone(Direct) 0.3

TSH 1.270
T4,Free(Direct) 1.27

FSH 5.6

Prolactin 8.2

Estradiol 12.2

DHEA-Sulfate 140.0

Yes, it covers the whole panel.
Now , for PCOS;
it is diagnosed as being present when 2 out of 3 are present -
1. Clinical picture - which you have - unexplained weight gain, acne, hirsutism, irregular cycles.
2. Biochemical picture - which shows up on blood work.
3. Ultrasound scanning - showing polycystic ovaries.
So, basically if you have symptoms and a scan or blood work supporting PCOS, the diagnosis is made.
If you do not have symptoms but the other 2, you still have it. You meet the clinical picture but the biochemical tests are normal. So an ultrasound scan is required.
Was a scanning done ? If it wasn't, please discuss with your doctor to get it done. You can upload the result here.
Feel free to discuss further.
Take care.

Dr. Aarti Vazirani
Category: Infertility Specialist
Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B.J. Medical College, Ahmedabad, 2004
Dr. Aarti Vazirani and 4 other Medical Specialists are ready to help you

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