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Are There Alternative Treatments For PCOS Other Than Metformin?
Question: Are there alternative treatments for PCOS other than Metformin? I am already watching my food and exercising regularly. I am not diabetic, but I do have hormonal imbalance. I am 36 years old. I am currently on Metformin, 500 mg 1x/day. Only one menstrual period for 2015 thus far. No pregnancies.
Brief Answer:
PCOS
Detailed Answer:
PCOS can be a fairly complex condition. It has various manifestations that tend to differ from person to person.
I have reviewed your attached lab results.
When I see someone like you I order the following tests:
HbA1c
Fasting Lipids
Prolactin
And based on findings of physical examination, I would also consider ordering the following
8 am 17 hydroxy Progesterone
Androstenedione
DHEAS
IGF1
Midnight Salivary cortisol
These tests help rule out other conditions that mimic PCOS.
Once these are ruled out, PCOS is the most likely diagnosis.
Treatment options depend on presenting problem. If it is your menstrual cycle irregularity that concerns you then hormonal treatments are your best chance.
If you are overweight/obese then losing 5 to 7 % body weight will help
PCOS
Detailed Answer:
PCOS can be a fairly complex condition. It has various manifestations that tend to differ from person to person.
I have reviewed your attached lab results.
When I see someone like you I order the following tests:
HbA1c
Fasting Lipids
Prolactin
And based on findings of physical examination, I would also consider ordering the following
8 am 17 hydroxy Progesterone
Androstenedione
DHEAS
IGF1
Midnight Salivary cortisol
These tests help rule out other conditions that mimic PCOS.
Once these are ruled out, PCOS is the most likely diagnosis.
Treatment options depend on presenting problem. If it is your menstrual cycle irregularity that concerns you then hormonal treatments are your best chance.
If you are overweight/obese then losing 5 to 7 % body weight will help
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I have been officially diagnosed with PCOS twice.
Fasting lipids:
Name Value Reference Range
CHOLESTEROL, TOTAL 148 125-200 mg/dL
HDL CHOLESTEROL 32 > OR = 46 mg/dL
TRIGLYCERIDES 216 <150 mg/dL
LDL-CHOLESTEROL 73 <130 mg/dL (calc)
CHOL/HDLC RATIO 4.6 < OR = 5.0 (calc)
NON HDL CHOLESTEROL 116 mg/dL (calc)
Prolactin came back within range, though I do not have the actual number available.
Also had an ultrasound that showed the typical polycystic ovaries. Normal uterus. I do have mild hirsutism: chest, belly, chin. No hair loss. Some body acne.
I am already losing weight. I am not overly concerned about irregular periods. I'm more concerned about overall health.
What mimics PCOS?
Fasting lipids:
Name Value Reference Range
CHOLESTEROL, TOTAL 148 125-200 mg/dL
HDL CHOLESTEROL 32 > OR = 46 mg/dL
TRIGLYCERIDES 216 <150 mg/dL
LDL-CHOLESTEROL 73 <130 mg/dL (calc)
CHOL/HDLC RATIO 4.6 < OR = 5.0 (calc)
NON HDL CHOLESTEROL 116 mg/dL (calc)
Prolactin came back within range, though I do not have the actual number available.
Also had an ultrasound that showed the typical polycystic ovaries. Normal uterus. I do have mild hirsutism: chest, belly, chin. No hair loss. Some body acne.
I am already losing weight. I am not overly concerned about irregular periods. I'm more concerned about overall health.
What mimics PCOS?
Brief Answer:
Follow up
Detailed Answer:
I see.
Looks like the diagnosis is mostly correct.
The conditions that mimic PCOS are:
Acromegaly
Cushing's syndrome
Congenital Adrenal Hyperplasia
I have not mentioned Hypothyroidism and Hyperprolactinemia in this list because your TSH in the attached lab report is normal and you say your prolactin was certainly normal too. These two conditions too can mislead one to believe there is PCOS.
For best long term overall health outcomes with PCOS, it is important to follow up regularly with an endocrinologist.
At the moment, seeing a Reproductive Endocrinologist would be best as you will likely benefit from hormonal treatment.
Follow up
Detailed Answer:
I see.
Looks like the diagnosis is mostly correct.
The conditions that mimic PCOS are:
Acromegaly
Cushing's syndrome
Congenital Adrenal Hyperplasia
I have not mentioned Hypothyroidism and Hyperprolactinemia in this list because your TSH in the attached lab report is normal and you say your prolactin was certainly normal too. These two conditions too can mislead one to believe there is PCOS.
For best long term overall health outcomes with PCOS, it is important to follow up regularly with an endocrinologist.
At the moment, seeing a Reproductive Endocrinologist would be best as you will likely benefit from hormonal treatment.
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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