Hi Barbie,
Based upon the history we have talked about today, some of the symptoms you have been displaying, and your lab work, I am going to diagnose you with Polycystic Ovary Syndrome. This is known as PCOS to some.
We typically diagnose PCOS based upon having two out of three criteria, which include having irregular ovulation, higher levels of male hormones like testosterone, and the appearance of polycystic ovaries during an ultrasound. We discussed that you were having irregular periods and difficulty tracking your ovulation cycles, and your lab work showed elevated testosterone. Being that you meet those two of those three criteria, that is why I am diagnosing you with PCOS.
While we don’t exactly know why you have PCOS, but it believed that there is a genetic component to it. I have a visual aid to help explain what is happening in your body. Over here we have a normal reproductive cycle displaying the ovaries, fallopian tubes, uterus, and vagina. During a normal reproductive cycle, once a month, hormones are secreted from your brain and they go to your ovaries and they cause your ovaries to eject an egg from a follicle, go to the fallopian tube, then the uterus. That is where fertilization would occur, and if that does not occur, that is when you get your menstrual cycle, or period. The main hormones in this process are called follicle stimulating hormone and luteinizing hormone. These hormones stimulate this process, but when you have PCOS, you have higher LH and may have lower FSH. This causes follicles to grow in your ovary without ovulation, which would explain why you have trouble getting pregnant and are having irregular periods.
That being said, some women with PCOS also have insulin resistance. Insulin is another hormone that helps you utilize sugar from the foods you eat. When this happens, that means that you gain weight and have more fat stores in your body. This would explain why you are having trouble with weight loss.
While there isn’t one specific cure for PCOS, we do treat a few different ways. One major way we treat it is with hormonal oral contraceptives, which would help even out your hormone levels, and will often help some women with weight gain, acne, and hair growth.
If you do want to get pregnant right now, we do recommend lifestyle modification, which includes a healthy diet and exercise, and losing excess body fat. If that is troublesome for you, we can link you with a dietitian, and we recommend getting 30 minutes to one hour of exercise per day. This is because weight loss can help with ovulation. That being said, if you are still having trouble, we can link you with an OBGYN, which is a doctor who specializes in women’s health. They can prescribe you with medication to stimulate ovulation.
Picture in Voice Thread retrieved from: https://www.news-medical.net/health/Polycystic-Ovary-Syndrome-and-Metabolic-Syndrome.aspx.
Patient education information retrieved from: McCance & Huether, 2019.