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Last week I had a transvaginal ultrasound to take pictures of my internal lady parts to ascertain whether polycystic ovary syndrome (PCOS) is really an issue. I won’t regale you with the details, but it’s an easy procedure.

The results? My ovaries are polycystic. They are covered in cysts, some of them large enough to require ongoing monitoring. If they don’t change in 4 months (it’s normal for them to go away after a few weeks), I’ll probably have to get a biopsy to rule out ovarian cancer. But the odds of that are slim and I’m not worried about it right now.

The gynecologist reviewed the sonograms and my endocrine lab results with me. Notably, it’s possible to have polycystic ovaries but not PCOS. However, she pointed out that my DHEA levels are abnormally high, which does suggest PCOS. High DHEA causes hyperandrogenism and contributes to insulin resistance, and can be caused by stress, depression, and PCOS. The GYN had some additional blood drawn to check some other details, among them insulin and cancer antigen (CA 125) levels. I’ve had low blood sugar problems since my teens, and hypoglycemia can be caused by insulin resistance (aka metabolic syndrome).

There are clearly a few more details to evaluate and I appreciate the thoroughness, but I’m glad I pushed for the ultrasound. I gained new respect for the GYN when she said that diagnostic criteria come in books and we shouldn’t fit the patients to the books, but rather the books to the patients. Rock on, holistic Indian gynecologist!

8/365 – Here’s to a Shrunken Cyst, by Phoney Nickle, CC BY-NC-ND.

I said that I’m willing to try hormonal birth control, so I have several sample packs of a very low estrogen pill. I waited to consult with the psych nurse before starting them because The Pill interacts with Lamictal, so I wanted to make sure that was not going to cause problems..

Hormonal birth control might help reduce the cysts and reduce the excruciating cramps. It could make acne worse (or better) and cause weight gain (or not.) It might also worsen mood swings – or make them better. Last time I took Ortho-Tricyclen, I gained 30 lbs in 2 months and had extreme mood swings. The pill I’m trying this time, Lo Loestrin Fe, has only about a quarter as much estrogen as what I took back in the mid-90′s, so perhaps it won’t cause problems. There’s no way to know until I try it. So today the experiment begins – wish me luck.

By the book, I have polycystic ovaries and symptoms of both hyperandrogenism and insulin resistance. So despite having normal periods, the evidence is mounting in favor of a PCOS diagnosis. Lovely, eh?

As Mr. Chickadee asked, what does this mean? It remains to be seen; the bottom line is, I have no idea what to expect, except further experimentation with meds. Regardless, I feel like I’m on a course that will get me some more answers. One way or another, I’ll learn more about how my body is functioning, and that empowers me to improve my lot.

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