To ask if you'd press the doctor about PCOS in this case?

[JustAKitten]

I've thought for years I have PCOS. Painful periods, although regularish that were unpredictable as in were often light, sometimes heavy and random spotting between cycles. I took the pill since my teens, then a mirena and then the mini pill. I got pregnant with my son on the mini pill.

I have extremely hairy arms, legs, I get my moustache waxed and have it on my stomach too. When I asked about this I was told it's just because I have black hair.

I've now got no periods after coming off the combined pill. Doctor assures me they'll come back eventually.

I had an internal scan while on the pill which showed no cysts, and a blood test that put my FSH as 6.1 and LH as 4.1. So my doctor thinks it's not PCOS.

In these circumstances would you push to be referred or to do a blood test for testosterone levels? Or should I just leave it?

I'm concerned that, while I'm not ttc, I want more dc in the future and this will cause problems.

Down to you. You may have mild pcos from what you say but a Doctor needs two out of three markers to officially diagnose you. (Physical symptoms as you describe, elevated hormone levels (PCOS will show in lh/fsh rather than testosterone) and presence of internal cysts).
Testosterone result won't assist diagnosis, just let you know the level.
How long have you been off the pill? It can take up to 18 months to right your hormones after coming off birth control.
What would be the ideal outcome of a formal diagnosis? If you have existing children and struggle with secondary infertility then you 'may' be offered metformin and Clomid if your bmi is within range but wouldn't be eligible for any further fertility treatments.
To help yourself in the meantime, you can maintain a healthy weight, follow a low gi diet to ensure optimum hormone balance and take a supplement called myo inositol. (Zita West clinic)

gin whats the myo inosital for?

The painful periods could be endometriosis, I've had mine burned off twice (have pcos too) and it doesn't show on a scan. Plays merry help with your periods. If you get very dark blood a couple of days before your period starts properly then that can be an indicator.

If it's causing you problems, whatever it may be that's causing it I think you should keep pressing. Just because they've ruled one thing out doesn't mean the problems have stopped.

It's because you've been on the pill or some other form of hormonal contraception. It can take 12-18months to sort it's self out again. Go do some exercise, eat less carbs and you'll be pretty OK in several months. Also some people are just hairy.

Painful periods are normally endo or an overreaction from your body to prostoglandins released when your uterus cramps and your cervix dialates to let blood out. PCOS doesn't actually cause painful periods. PCO does and you don't have cysts so no PCO. Two different things both commonly assumed to be the same, one is a condition, one is a syndrome.

I have 'mild' PCOS without cysts/definitive blood test results but have horrid 'ovulation' pain. I have irregular and heavy periods that last over 7 days. I also spot brown blood a week before my period. My gaene told me that and my infertility is consistant with PCOS, not necessarily body hair. Your cycles may be out of whack for a number of different reasons. Best to get yourself checked out.

For PCOS as PP have said you need to have at least 2/3 of the following diagnostic criteria

1. Irregular or absent ovulation
2. Clinical or biochemical signs of hyperandrogenism
3. Polycystic ovaries on ultrasound

PCOS actually isn't cysts, it's multiple follicles within the ovary. Really it should be called polyfollicular ovaries

It's possible to have PCO without the syndrome - about 1 in 5 actually have polycystic ovaries but no symptoms

It's very unlikely to have PCOS the syndrome without having polycystic ovaries. That said, you had the scan done when on the pill. The pill affects hormones so a transvaginal ultrasound to assess the antral follicle count isn't terribly helpful when on the pill.

it's more likely the periods are to do with coming off the pill. Are you overweight?

Classic PCOS is actually much easier to treat. Ovulation can often be restored through low GL diet and weight loss plus metformin. Many people will find their PCOS symptoms are improved

I'm lean PCOS (I'm actually underweight) which is actually harder to treat, because losing weight won't solve the problem

Anovulation for TTC can be treated in the first instance with clomid. Your periods may well return after the pill, would be advisable to track your cycles, and if no period 6 months after coming off the pill then your GP should do more investigations

They should also give you provera or norethisterone to induce a bleed every three months to reduce the risk of unopposed oestrogen

Thanks everyone. They've thought about endo before, it's in my family. I also get horrid pain in the middle which I have assumed to be ovulation pain.

Have only been off the combined pill for the best part of two months so I'm aware it might take a while to sort, I didn't even get a bleed at all though.

As for what I'm hoping to get out of a diagnosis, the knowledge that I may have a difficult time ttc so we can decide when to try and if we need to save for ivf privately.

If you previously had periods and managed to get pregnant whilst on the pill it sounds like you're less likely to suffer from anovulatory related infertility

I'm not overweight but I'd describe myself as chubby. Healthy BMI though.

Even if you're normal BMI it's sensible to eat low GL as PCOS is an endocrine disorder whatever your weight

I'm underweight but still on metformin for my PCOS

There's no reason why you should be leaping to IVF already

Clomid is available in most CCGs even if you already have a child. Ovulation induction cycles with timed intercourse are also much cheaper than IVF so no reason why you should be going straight to IVF until you've tried ovulation induction IF you were to have anovulatory PCOS

Two months off the pill is nothing. My GP only did investigations into my absent periods after 6 months off the pill

with your age Op you need to move fast if you want to ttc. The symptoms could easily be menopause/peri-menopause. Get yourself a referral!

@UppityHumpty with that FSH level there's absolutely no way it's peri

FSH levels in peri would be 20+

That's a very healthy FSH level. Why would you suggest peri when the evidence is anything but? That seems to be unnecessarily worrying and I'm not sure what you're basing it on at all

I'm 22 so I wouldn't think my age is a problem

There is absolutely no way you're in peri menopause at 22 and with that FSH level OP. No idea what Uppity is on about

banana thanks for the info that's very helpful.

I think I'm jumping to IVF because I worry too much about things.