I'd get a test for swabs of BV, thrush etc, and other potential infections just to check if you have anything. It is likely just discharge which is normal and mixed in with cervical mucus when the blood is coming out.
On your PCOS it can cause heavy and painful periods, and pain in general so I'd focus on how well your PCOS is currently now, both outwardly or inwardly.
Also since you haven't been treated for a while for PCOS, book a GP appointment and get them to do a whole set of bloods, and also some other hormones, again cholesterol and insulin tests, as well.
Blood test wise I'd probably ask for:
• Total testosterone
• Sex Hormone Binding Globulin
• Free Androgen index
• Fasting glucose + insulin
• Lipid panel (cholesterol, triglycerides)
• Vitamin D
• Thyroid panel (TSH, free T4)
Hirtuism blood panel as well.
Then you do need to start some form of contraception (Yasmin work very well for PCOS as does the mirena coil) because you need uterine protections especially as with PCOS it can be a 2-5 x higher risk of uterine cancer, so it is so important to protect from that.This video explains it in quite a lot of detail but very understandable as well, definitely have a watch www.instagram.com/reel/DPRWvOkEeGJ/?igsh=dDJlMjc4dGxmbHh5
PCOS is medically defined as hormonal deregulation - a different thing, so it is not using the hormones it has (which are in the right amounts) properly. So insulin resistance is common in PCOS because your body procedures insulin but doesn't respond to it correctly, the same for androgens etc. PCOS is more about bio-chemistry and genetics which you cannot fix, lifestyle changes, hormonal meds etc can help to managae it and get your body to regulate and respond and flucatate hormones properly. You need to fight bio-chemistry with bio-chemistry; meds.
The pill is there to protect you, to treat the symptoms, it treats PCOS, if anything it is the best for the PCOS, that is the point. It is a treatment for acne, it treats heavy periods, missed periods, irregular periods, it treats hirsutism, it treats the risk of uterine cancer. Saying that it 'masks' PCOS is like saying 1. PCOS symptoms are normal, which they are not, and like insulin masks diabetes.
With PCOS even at a healthy weight you can still be insulin resistant, or have elevated androgens (even without excessive hair etc). This is the case for around 20-30% of women with PCOS, so definitely get the bloods to see as there are a range of different treatments for lots of the potential symptoms of PCOS which is why it is known as a syndrome.
Also get a pelvic and transvaginal scan to see how things are, you may have cysts or polyps, and follicles which are 1 of the 3 PCOS diagnostic criteria. They can cause pain sometimes, and bloating, and also polyps etc can cause some of the mucus discharge you have as well.
PCOS can be managed but not cured - managed with interdisciplinary care of endocrinologist, dietitians, gynaecologists etc. So once you have the bloods, the transvaginal scan, go back to your GP assess the results and see who you may need referrals to and what meds you may need to start. So metaformin or orlistat, Yasmin, the mirena, etc. What other symptoms do you have? Acne? Excessive hair growth or hair thinning?
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