Dr. Daswani Deepti Puranlal
Obstetrics and Gynecology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
Kindly review my laboratory reports and tell me if this is indicative of PCOS. I have very tender breasts, fatigue, hair loss on my scalp and eyebrows, hair growth on my chin, and I have started gaining weight. I am constantly thirsty, and my appetite is out of control. Cholesterol levels were high due to not fasting at the time of laboratory tests. I am currently taking below mentioned medication:
I did have a positive ANA before. Kindly help.
Hello,
Welcome to icliniq.com.
I read your query and understood your concern. I have reviewed the reports you attached (attachments removed to protect the patient’s identity), the lipid profile, which was altered due to fasting, is the only abnormality. Other reports, including hormone profiles (Luteinizing hormone, follicle-stimulating hormone, testosterone), thyroid profile, and BMI (basal metabolic index), are normal. Regarding the complaint of tender breasts, if there is no associated mass or discharge and it is linked to the menstrual cycle, it might be cyclical mastalgia. This can be treated with hormonal medication or painkillers if the discomfort is significant. Hair loss is more likely related to thyroid issues rather than PCOS (polycystic ovarian syndrome). However, facial hair growth (hirsutism) is associated with PCOS, but in this case, the hormone responsible, testosterone, is normal, making it difficult to pinpoint it as the sole reason. For a definitive PCOS diagnosis, I suggest you undergo an ultrasound of the abdomen and pelvis. Based on the current laboratory reports, PCOS does not seem to be the primary concern. I suggest you incorporate exercise and a healthy diet as it will help address these issues. I hope this has helped you. Kindly follow up if you have more doubts.
Thank you.
Patient's Query
Thanks for the reply doctor,
I would like to inform you that I do eat a healthy diet, and I work out about five times a week, but I am still gaining weight. My primary doctor suspected PCOS due to my LH:FSH ratio and my estrogen levels. I have also had a hysterectomy, so it is hard for me to know what part of my cycle I am in. I wanted a second opinion because there were discussions about starting me on Metformin. Kindly help.
Hello,
Welcome back to icliniq.com.
I read your query and understood your concern. You mentioned a hysterectomy, which involves the removal of the uterus. How does PCOS come to mind then? PCOS is a condition characterized by the presence of follicles in the ovary, along with irregular anovulatory menstrual cycles and features of hyperandrogenism such as excessive hair growth. To have a definitive diagnosis, we need a detailed medical history. In general, according to research, Metformin is effective in managing PCOS. Additionally, you are on a steroid. Continuous use of steroids can lead to weight gain as well. I hope this has helped you. Kindly follow up if you have more doubts.
Thank you.
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Obstetrics and Gynecology
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