How is PCOS dx'ed?

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SoBayAsker
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Joined: Tue May 28, 2013 5:29 pm

How is PCOS dx'ed?

Post by SoBayAsker »

What constellation of symptoms leads to a PCOS dx? My USes (at Reproductive Partners) have shown that my ovaries have a polycystic appearance, my unmedicated cycles are 40+ days long, and since coming off oral contraceptives, I've developed acne along my jawline. But at this time, no PCOS dx has been made. Is there a quantitative lab value that we'd be looking for such as testosterone?

I lack some of the common signs of PCOS, so I'm curious. I'm of normal weight and physicals have shown normal A1c over the years, though I've always been on oral contraceptives. The 8 dpo progesterones I've had show ovulation with and without Clomid.

We are about to start our 4th round of Clomid and plan on scheduling a trigger shot. Would the addition of metformin be appropriate?

All my questions in one place:
1. What constellation of symptoms leads to a PCOS dx?
2. Is there a quantitative lab value that we'd be looking for such as testosterone?
3. Would the addition of metformin be appropriate?

Thank you!
Dr. Wisot
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Posts: 1208
Joined: Fri Oct 14, 2005 11:16 am

Re: How is PCOS dx'ed?

Post by Dr. Wisot »

PCOS is a syndrome, not a disease so there are not strict criteria for making the diagnosis. The two features that all PCOSers are supposed to have are irregular menses and an increase in androgen type effects such as acne, excessive hair growth and obesity. Beyond that there is a lot of variation from person to person.

There is no clear lab value that makes the diagnosis. Some clues could be an LH much higher than FSH, and a high insulin to glucose ratio showing insulin resistance and a high testosterone, but again, none of this is diagnostic.

Based on your individual situation (and you have not even been diagnosed as PCOS), your doctor is the one to ask if it would benefit you.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California
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