Dermatologist, endocrinologist or gynaecologist?

[BlueberryFool123]

I have endometriosis. Finished breastfeeding last child beginning of this year.

Have always had acne. Was on combined pill for acne and heavy periods which was great. Came off to conceive. During pregnancy and breastfeeding - not great.

Acne is worse then ever - jaw line and neck mainly. Cystic in places. Worse during period.

I’m over 35 and overweight so I am almost certain doctor won’t recommend going on combined pill - also I don’t think I can just stay on that till I hit menopause and hopefully my hormones calm down.

Hairdresser has said my hair is thinning.

Have always struggled with weight (just been told to eat less and move more. Only way I kept my weight down when I was younger was to eat 1200 Cals (and I’m tall) and exercise every day).

There clearly is something hormonal going on. I was planning to get a referral for dermatologist for acne (have private health insurance), but now I wonder if I should be seeing if there is a more underlying problem. Is there anything that could be done if there was? Or should I just focus on clearing up the acne?

Any thoughts similar/experiences would love to hear.

Have you had your thyroid tested? First step.
Weight? You working on that?

I'd see a dermo first to start treatment and they may decide to refer to a gynae.

Haven’t had any tests. Going to gp on Wednesday.

Weight - going to gym, intermittent fasting. Not gaining any weight, but not losing either.

I would be wondering if a condition called polycystic ovaries or its related syndrome PCOS is to blame for your acne. It’s something that can be determined through blood tests and internal ultrasound scans to see what your ovaries look like.

A referral to a gynae should be made by the GP in the first instance.
You need a diagnosis first and foremost.

I think a good endocrinologist would be your best bet.

I work for a referrals team who deal with private hospitals and gps and the insurance companies. You will need to go to your GP who will tell u who to be referred to privately anyways before your insurance will cover it to make sure you have the right specialist and they cover that speciality then they will tell you the consultants they will cover at the hospital. So first stop will be your gp

You might need all three.

Start with thyroid (t4, t3, antibodies) vitamin d, bit b12, sex hormones blood tests.

That will determine where you go next.

Dermatologist can consider roaccutane or anti androgens for acne.

Endocrinologist can deal with thyroid.

Thanks for all the helpful information

The hair thinning is a classic symptom of hypothyroidism. But could also be caused by hard water (so can acne).

I live in a very hard water area