Diagnosing PCOS is not an easy task as each woman’s symptoms and experiences are different. There is no specific set of symptoms to look for, nor is there a specific test that doctors can perform to reach a PCOS diagnosis. When a women has irregular cycles or no menstrual periods at all, along with acne, obesity and excessive hair growth, it is a sign that ovulation may not be happening…
HARD TO DIAGNOSE
PCOS is a disorder of chronically abnormal ovarian function and hyperandrogenism (abnormally elevated androgen levels) and it affects 5-10% of women of reproductive age.
Diagnosing PCOS is not an easy task as each woman’s experience is different. There is no specific set of symptoms to look for, nor is there a specific test that doctors can perform to reach a PCOS diagnosis. When a women has irregular cycles or no menstrual periods at all, along with acne, obesity and excessive hair growth, it is a sign that ovulation may not be happening. With symptoms such as these, doctors will attempt to rule out other causes of irregular or absent periods, including the following: thyroid disease, Cushings syndrome, adrenal hyperplasia and hyperprolactinemia.
Once other potential conditions are ruled out, your fertility specialist will do a complete physical, including a pelvic exam. Typically, the doctor will check for external, physical signs of hyperandrogenism, such as acne, abnormal hair growth found on the chest, back, lower abdomen, and face, skin tags, and darkened thick skin on the neck, thighs, armpits or vulva. As part of your physical, your fertility specialist will also be interested in any other unusual symptoms you may experience, along with information regarding your menstrual periods. In order to determine if you are actually ovulating, your doctor will want to know how regular your periods are and the length of time between them.
Depending on your symptoms and information regarding your cycles, your fertility specialist may perform a trans-vaginal ultrasound. With this particular procedure, an ultrasound probe is placed inside the vagina; this gives your doctor the chance to examine your reproductive organs, looking for potential issues or abnormalities, such as ovarian cysts. Doctors in Europe often give a diagnosis of PCOS when 12, or more, small (2 to 9 mm) follicles are found in each ovary. However, in the United States, most fertility specialists often do not rely solely on that specific definition in order to make a PCOS diagnosis. Many women have no symptoms of hyperandrogenism, but still have cystic ovaries, and are diagnosed with PCOS even though they do not have classically cystic ovaries. Therefore, the European definition of PCOS is too narrow for specialists in the U.S.
Lab work is another necessary step in diagnosing PCOS. Your fertility specialist will request blood work for testing several different hormones, including testosterone, prolactin, Lutenizing Hormone, and Follicle Stimulating Hormone. In addition, your blood may be tested for other related problems such as insulin resistance and high cholesterol.
Based on the information that you discuss with your doctor, an endometrial biopsy may be suggested to test for endometrial cancer or to see if endometrial tissue is in the correct phase. It is important to note that the possibility of endometrial cancer rises with the number of and length of time between missed periods. The biopsy procedure can be completed at the fertility clinic or doctor’s office. It is a fairly painless process, although you may experience minor cramping while the biopsy is taken. From the uterus a small amount of tissue is removed via a thin catheter that is placed through the cervix and into the uterus. The tissue that is removed is subsequently evaluated in the context of your current menstrual cycle; it is also examined for cancer cells.
Depending on the results of the doctor’s examination and the blood work, along with the results from the procedures listed above, you may very well receive a diagnosis of Polycystic Ovary Syndrome. It is important to remember that you are not alone. PCOS is, in fact, the most common endocrine disorder among women of child bearing age. The best way to manage PCOS is to follow your doctor’s advice. Learn about the disease and reach out to those who care about you. In fact, reaching out to a support group may also be very helpful. There are many resources available to you, from education to message boards and internet chats, that provide ample support.
WHERE TO TURN
If you have irregular menstrual cycles or no periods at all, consider seeking specialized assistance at an infertility clinic. The fertility specialists and professional staff at the Center of Reproductive Medicine (CORM) are well known for their high level of success in helping couples to conceive. CORM serves the greater southeast Texas area with three state-of-the-art fertility clinics located in Houston, Webster, and Beaumont. At CORM, our professional staff is committed to providing the highest quality reproductive medicine, ensuring exceptional care is given to every patient/couple undergoing fertility treatment.
If you are having trouble getting pregnant, or if you have other questions, it may be time to make an appointment with a reproductive specialist. Call our knowledgeable staff at the Center of Reproductive Medicine (CORM) today. CORM serves the greater southeast Texas area with three state-of-the-art fertility clinics located in Houston, Webster, and Beaumont. Our highly trained doctors will work with you to determine appropriate testing needs and they will help you choose the best fertility program for your individual reproductive medical needs.