Do you think you have PCOS? Here are 3 tips on how to proceed, as this disease is often misdiagnosed
Acne, excessive hair or depression. Many women have PCOS, they have no idea. This was the title of the first article on PCOS, which should be read by any woman who wants to know more about this issue. In short, it is one of the most common endocrine diseases and many women do not even have a diagnosis. Today we will continue and reveal how you could proceed if you think or have been told that you have (probably) PCOS.
I probably have PCOS! What now?
Recognize phenotypes (sum of all observable properties) and types of PCOS
Educate yourself and write down information about your health condition
Professional assistance and physical ultrasound and laboratory examinations by specialists
Let's take a closer look.
# 1 Phenotypes and types of PCOS according to the best known sources
The Rotterdam criteria describe the following four PCOS phenotypes:
Polycystic ovaries visible by ultrasound, elevated androgen levels and irregular menstrual cycles (also known as "complete PCOS")
Polycystic ovaries visible by ultrasound and irregular menstrual cycles
High androgen levels and irregular menstrual cycles
Polycystic ovaries visible by ultrasound and high levels of androgens
The four types of PCOS according to Dr. Fiona McCullough are:
Type A (Classic PCOS): elevated androgen levels + symptoms of these elevations, irregular menstrual cycles / delayed ovulation, polycystic ovaries
Type B (Classic PCOS): elevated androgen levels + symptoms of these elevations, irregular menstrual cycles / delayed ovulation, normal ovaries (not polycystic).
Type C (Non-Classic PCOS): elevated androgen levels + symptoms of these elevations, regular menstrual cycles - 35 days or less, polycystic ovaries
Type D (Non-Classic PCOS): normal androgens, irregular menstrual cycles / delayed ovulation, polycystic ovaries
The four types of PCOS according to Dr. Lary Briden are:
Insulin resistance: elevated levels of insulin, glucose, abnormal OGTT (Oral Glucose Tolerance Test) results, and in some cases elevated LH levels
PCOS "caused" by hormonal contraception: hormonal contraception suppresses ovulation, which usually returns after stopping treatment, but in some cases it takes months or even years
Inflammatory PCOS: caused by chronic immune activation caused by stress, environmental toxins, intestinal permeability and "inflammatory" foods
PCOS with a "hidden" cause: caused by something that blocks ovulation, such as low levels of progesterone (chronically elevated cortisol), thyroid disorders, HPA (hypothalamic-pituitary axis) or HPO Axis (hypothalamic-pituitary-ovarian) dysfunction, low-carbohydrate diets, etc.
# 2 Educate yourself and write down information about your health
As you can see, there are many types of PCOS that are specific to both symptoms and laboratory results, so it's important to know yours. The diagnosis of PCOS is very complex, as is PCOS itself. There is no treatment to get rid of it completely and the overall management of PCOS is complex and individual. There are not two people with the same symptoms, prognosis and treatment.
This is not the case, for example, with any bronchitis or peanut allergy. Symptoms -> examination -> results -> treatment = often the same in several people. PCOS differs not only in how it is presented, but also in how it needs to be treated or rather managed. Although the definitive cause is not fully known, there are certain elements that cause PCOS. It is more often a combination of them than the one itself, and finding them helps to identify a given type of PCOS.
So why observe your health and write down information? As I mentioned in the previous article, each body reacts differently, and the more you get to know yours, the more you will help yourself and your doctor diagnose and set up treatment for your PCOS, because it is difficult to remember all the symptoms and difficulties with a time-limited visit.
Write down:
Symptoms: when they occur, which improves or worsens them, how long they last, when they started to appear (after stopping contraception, after diet, during a more stressful period, etc.)
Information on the menstrual cycle: regularity, cycle length, presence of PMS (premenstrual syndrome), length and intensity of bleeding, presence of ovulation (eg basal temperature measurement). If the cycle is irregular, record when and to what extent (eg every 4 months, every six months). If you suffer from amenorrhea (absence of menstrual cycle), mark when and after what period you stopped menstruating.
Symptoms during the menstrual cycle: pain (type of pain, incidence, duration, etc.), digestion / bloating, mood swings, acne, hair loss, fatigue, weakness, length, symptoms and intensity of PMS.
This information will be a very helpful aid, along with other results, in diagnosing / disabling diagnosis and determining treatment. This information will also often help women have a greater sense of power in this case, when most of what is happening is not in their hands.
# 3 Professional assistance and physical ultrasound and laboratory examinations by specialists
As I mentioned, before you jump to the conclusion, "Oh God, panic, I have PCOS!", Seek professional medical help. Even if your GP goes on first and sometimes only for gynecology, it is worth visiting an endocrinologist who specializes (as in the name) in endocrinological disorders, and PCOS is one of them.
Hormonal profiles:
Many times the basic hormonal profile examined for gynecology is "normal" and the doctor will send you home with the understanding that everything is in order. However, in the "norm" because the basic hormonal profile does not investigate in more detail and does not address individual hormones and things such as ratio of one hormone to another (which is, for example, very important for determining estrogen dominance, progesterone deficiency and the like.
Another very important thing about hormonal blood tests and the menstrual cycle is that hormone levels as well as "norms" change during the month, so it is important that all phases of the menstrual cycle are tested. However, this method can be more complicated for those who have an irregular cycle or amenorrhea, and therefore it is necessary to have the other information I mentioned in the second point.
Insulin and glucose:
Examination of insulin and blood glucose levels is also very important, but rarely recommended by physicians when diagnosing, respectively. in the treatment of PCOS .. I had these tests done from my own experience, knowledge and costs without the recommendation of doctors, based on the symptoms I had. Since I'm not overweight and I'm not obese, many doctors have said, "Because why do you deal with details like insulin, when you're not obese, you can eat whatever you want and not deal with insulin" ... As a matter of fact? And the fact that I had all the symptoms of insulin resistance was not taken into account by anyone until I came up with the results of these tests, which I requested in my lab at my own risk.
Vitamin D levels - are reduced in some cases of PCOS
Sex hormone binding globulin (SBGH) - is reduced in some cases of PCOS
Androstenedione - is increased in some cases of PCOS
Anti-Müllerian hormone (AMH) - Elevated levels are often seen in patients with PCOS
These tests help to exclude some potential diseases (which have a similar presentation to PCOS) from the list when diagnosing PCOS:
Thyroid-stimulating hormone (TSH) and antibodies / thyroid function - to rule out thyroid dysfunction - thyroid dysfunction
Cortisol - to rule out Cushing's syndrome
Prolactin - to rule out increased prolactin (hyperprolactinemia)
17-hydroxyprogesterone - to detect the most well-known form of congenital adrenal hyperplasia
IGF-1 - to eliminate increased levels of growth hormone (acromegaly)
DHEAS - often slightly elevated in PCOS, tested to rule out adrenal tumors in women with rapidly worsening hirutism
This information should be used to confirm or exclude PCOS. It is really very important to have all the information together, as PCOS is one of the most common misdiagnosed or overlooked endocrine disorders and the diagnosis often takes months, in some cases up to years. In the next section, we'll talk more about how to proceed once the diagnosis has been confirmed, how to adjust your lifestyle (diet, physical activity, etc.), as these (often the most important treatment factors) do not talk much about doctors.
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