Mixed PCOS diagnosis ....... any ideas?

[Danilou22]

Hi,

One doctor looked at my blood test results and said yes I have PCOS. Another looked at them and said he was not sure. I had a scan today and there was no sign of PCOS when they looked at my overies.

So, what do you think have I or haven't I??

Anyone with any experience of this?

Apparently you can have PCOS without having visible cysts (or more accurately follicles) on the ovaries. Blood tests are, I think, looking at progesterone levels and these must be mid-luteal phase progesterone, which is CD21.

The syndrome is having a number of signs or symptoms: so classically it would be cysts on an ultrasound, plus excess hair and weight (that's me!). But I think you could have some of the symptoms and not others. So irregular or infrequent periods, anovulatory periods, mid-luteal progesterone levels that suggest it, weight gain, hairness, etc.

What prompted the blood tests and scan?

Danilou,

What hormone levels were looked at?. Did they check and compare your LH level against that of your FSH level on day 2?.

The cystic follicles associated with PCOS can and do disappear - only to be replaced by further cystic follicles. It can also take a skilled sonographer to spot these follicles as they are very small. You should have more than one ultrasound scan done (I used to go weekly to hospital, was there 3 weeks out of 4 over a period of several months).

PCOS is a very individualistic disorder and affects each woman with it very differently. The commonality though is the cystic follicles on the ovaries.

I was diagnosed with PCOS based on the bloodwork (this showed a clear LH/FSH imbalance), ultrasound scans and irregular periods.

Attila - you there?

I have had a similar experience as you.

I was diagnosed as a teenager as having PCOS (in the days when it was virtually unknown) through blood tests. In the last few years I have had various scans of my ovaries and they appear completely normal. I spoke to the consultant about this and he said that this means that I categorically do not have PCOS.

attila - you always sound so wise....and have answered a number of my queries before. I posted a personal question under the conception threads and it hasn't had any response. Would you mind having a look and giving any advice?

(sorry to hijack your post, danilou)

That's ok Miffles!

The reason I had the blood work was due to 5 months without a period when I stopped the pill.

The diagnosis was comapring my LH and FSH levels but it wasn't on day 2 because they took blood on the tuesday and then I got my first period after stopping the pill the next day so it was late in my cycle. Would that effect the levels Atilla?

Thank you all for your responses x

Just bumping this back up to see if anyone else has any words of wisdom.

I am a little overweight (but to be honest I do love my food so not sure it is medical) but other than irregular periods since I stopped the pill I do not have any other symptoms associated with PCOS e.g I am not hairy, don't have acne, don't have mood swings etc.

A couple of comments from me which might be of interest.

First off there is a difference between polycysitic ovaries and polycistic ovary syndrome. the first of these means literally that you have multiple cysts on the ovaries. The categoric diagnosis of you not having this could mean that.

Polycystic ovary syndrome is, as mentioned by miffles above is having a number of signs or symptoms: possibly including cysts on an ultrasound, anovulatory periods, excess hair and gaining weight easily.

Thus far I got from googling... feel free to make your own judgement as to how accurate that might be...

Then spoke to GP. GP said that they look at three different things when trying to work out if you have PCOS (the syndrome).

• Blood tests, as Attila pointed out this is comparing the LH and FSH level and must be at the right time in your cycle.
• Other symptoms, ie the weight, hair acne thing
• Ultrasound of ovaries, ie do you have cysts.

All of this sounds very good but I still did not see why they call it polycystic ovary syndrome if its possible you don't have cycts on your ovaries? So I askjed my fertility consultant and he was kind enough to explain,

the cysts on the ovaries can come and go with the syndrome, you might have some months where you are fine and others where you've got piles of cysts (apologies for bringing piles into the conversation unintentional )

Now the bit I don't quite understand is what about this whole situation is it that makes it hard to conceive. Is is the cysts? And is this because the prevent ovulation? or just make for bad eggs? or is it the hormonal issues? (Nobody seems to be able to give me a straight answer as to whether PCOS is caused by hormone imbalances or whether the hormone imbalances are caused by PCOS Sigh.)

OK sorry for the ramble but wanted to set down my full tuppence worth - needless to say I'm not a medic - but then the medics can't seem to come up with a consitent story so ho hum...

Good luck in any case.