My body is producing lot of male hormones. How do I rectify?

Question

Hi doctor,

I have a sickle cell trait. I was diagnosed with PCOS and PMDD. I got a colonoscopy done for chronic constipation. But, the report was inconclusive. My main concern is that, my body is producing lot of male hormones. Due to which, I have a lot of facial hair and have a deep voice.

On a regular basis, I have low blood sugar as well as low blood pressure, chronic fatigue, and chronic lower left abdominal pain. My periods are regular, but they are very heavy. I do have shortness of breath, muscle ache, headache, nausea and weight gain issues. Also, I am dealing with depression, mood swings, trouble to concentrate and at times insomnia. I am taking tablet Metformin. I am attaching all my reports for your reference.

Please check them and guide me accordingly.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I have gone through your reports (attachment removed to protect patient identity).You have multiple issues with your hormonal levels. I will provide some guidelines which you can proceed with:

1. Your TSH (thyroid-stimulating hormone) is very low. This means you are overproducing thyroid hormones and having hyperthyroidism. This causes anxiety, anger, palpitations, fatigue, muscle pain, intense bleeding during periods and depression and also leads to weight loss. Treatment is carried out by using antithyroid drugs such as Neo-Mercazole (Carbimazole). The dose can only be calculated by proper examination and evaluation of the patient. It is not safe to administer this drug just by seeing a report.

2. Your HbA1c (glycated hemoglobin) is 6.5. Hence, you are considered to be mildly diabetic. It can be either due to excess cortisol production or due to frank pancreas failure. After thorough evaluation, if cortisol is the cause, then we can start steroid reducing drugs. This has to be adjusted as per your body type. If overdose administered, it is dangerous. If there is frank diabetes, then you can be take small amounts of OHA (oral hypoglycemic agents) such as tablet Glimepiride or Dipeptidyl peptidase- 4 inhibitor (DPP4I) or go with peroxisome proliferator-activated inhibitor (PPAR).

3. To check why there is rise of A1C, I would suggest you to get your blood insulin levels checked.

4. Intense bleeding and pain during your periods is mainly due to multiple fibroids. It can be treated with surgery. If you have grown up kids then you can go for removal of uterus which will give you complete relief. Else, you can go for myomectomy procedure which is cutting the fibroids. In second case, there will be relief to a large extent but cannot be cured completely. Use hormonal pills like Oral contraceptive pills (OCP) to give relief when done non surgically. But, it will not last long.

5. The high testosterone levels, hair growth, weight gain, hoarse voice all are due to polycystic ovarian syndrome (PCOS). There is no permanent cure for this problem. Depending on your examination, generally start with tablet Metformin. But it has not worked in your case. Next option is to take hormonal injections to increase follicle stimulating hormone (FSH), luteinizing hormone (LH) and estrogen and reduce testosterone.

6. We can do an ovarian drilling to increase egg release along with regular exercise. When all this fails, we go for intense treatment and do an ovary removal to reduce abnormal hormone production.

Since multiple hormones are involved in your case, doctor will not be able to adjust the dosage without physically examining you. I would suggest you to consult a good physician and get them treated as soon as possible.

Thank you for reading.

I hope this helps.

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