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- Sun Sep 09, 2007 7:02 pm
26, female. I have no children and have never been pregnant.
Hx: depression (40mg prozac q day), seasonal allergies/asthma (20mg singular q hs, 250/50 advair BID), atopic dermatitis, severely dry skin.
Surgical hx: exploratory laparoscopy (2006), wisdom teeth excision (1999).
- father: CAD, DM type 2, hyperlipidemia
- mother: hypothyroidism, hypotension, anxiety
- grandmother: hyperparathyroidism (with excision)
- there is also breast and colorectal cancer & lymphoma in both maternal & paternal grandparents.
Okay, so here's my problem.
Via testing, I have learned that I have low estrogen and high LH.
My electrolytes, TSH, ESR, ANA, RF, and CBC are all normal.
I am experiencing oligomenorrhea and anovulation. I am constantly fatigued, my muscles and joints (mostly in my legs) hurt despite exercise and physical therapy. I also have recurrent headaches, sometimes migraines. These have been problems for me since high school.
My NP has suggested asking my OB about PCOS, but I do not have any signs of hirsuitism.
I recently graduated with my RN and have just started working towards a master's degree, so mental retardation is not a factor here.
I am not asking you to diagnose me. I need some suggestions so that I can research and work with my doctors and NP's to find a resolution to my problems.
Also, does this sound like something I should see an endocrinologist about? Or would family practice or an OB-GYN be appropriate?
| Dr. Chan Lowe
- Sun Sep 09, 2007 9:11 pm
When the LH is elevated, typically PCOS is thought of. Often, the LH:FSH ratio is helpful in diagnosing PCOS also. With PCOS, the LH:FSH ratio (typically about 1:1) will be elevated to about 2-3:1 or even higher.
Prolactin should also be tested to be sure it isn't an elevation of prolactin causing your problems.
Hirsutism is not necessarily required for the diagnosis, nor are cystic ovaries.
Seeing your OB is a good place to start. If your OB has trouble an endocrinologist will be appropriate.