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I Quit The Pill In February After 12+ Years. I
Question: I quit the pill in February after 12+ years. I had one ovulatory cycle of 42 days. It is now 90 days into my second cycle and nothing. I tested my hormones and I only have two abnormal results: high androstenedione (4.30 ng/ml, the lab range with 0.3-3.3) and high LH it is 21.9 which is in the ovulatory phase range for my lab, so not super high but not good since I'm not ovulating. I also had multiple positive OPKs these 3 months. Also, LH:FSH ratio is about 3:1. DHEAS, testosterone (free&total), SHBG are all normal. TSH, estradiol, also normal. Any thoughts?
Brief Answer:
Possible causes of your concern;
Detailed Answer:
Hello and thank you for asking!
I have gone through your concern carefully.
The hormonal results you reported and the history of ovulation is suggestive for the polycystic ovarian syndrome.
You didn't mention the reason why have you been taking contraceptive pills (only for contraception or for any other reasons)...
Do you have any ultrasound report for the last few months?
Prolactin is another hormone that should be checked in order to exclude other hormonal imbalances before blaming PCOS.
Insulin level and fasting glucose would be of help too to calculate insulin resistance that would be another data supporting PCOS.
Hope the information will help.
Let me know I can assist you further.
Best wishes,
Dr.Mirjeta
Possible causes of your concern;
Detailed Answer:
Hello and thank you for asking!
I have gone through your concern carefully.
The hormonal results you reported and the history of ovulation is suggestive for the polycystic ovarian syndrome.
You didn't mention the reason why have you been taking contraceptive pills (only for contraception or for any other reasons)...
Do you have any ultrasound report for the last few months?
Prolactin is another hormone that should be checked in order to exclude other hormonal imbalances before blaming PCOS.
Insulin level and fasting glucose would be of help too to calculate insulin resistance that would be another data supporting PCOS.
Hope the information will help.
Let me know I can assist you further.
Best wishes,
Dr.Mirjeta
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Thank you for your reply!
My prolactin levels are also very good. I don't know about my insulin or fasting glucose. I am rather skinny (not too much but I'm at an "ideal" weight) and my doctor said it's unlikely I'm insulin resistant. I did read they are not necessarily connected. Do you think I should insist to get tested?
The pelvic ultrasound revealed a few small cysts but only about 4-5 on one ovary and 2-3 on the other. All I've read indicated with PCOS there will be more cysts, but combined with the blood work, I'm guessing that might still be the issue?
I was on the pill initially to "regulate" my cycles. I think the first time I was given the pill I was 14-15. Sadly, I know it was not a very good idea, as it can take years for the period to properly regulate in young girls, but I listened to my doctor. I took it on and off till I was 20. Then at 20 I became sexually active and stayed on the pill without breaks for contraception.
My prolactin levels are also very good. I don't know about my insulin or fasting glucose. I am rather skinny (not too much but I'm at an "ideal" weight) and my doctor said it's unlikely I'm insulin resistant. I did read they are not necessarily connected. Do you think I should insist to get tested?
The pelvic ultrasound revealed a few small cysts but only about 4-5 on one ovary and 2-3 on the other. All I've read indicated with PCOS there will be more cysts, but combined with the blood work, I'm guessing that might still be the issue?
I was on the pill initially to "regulate" my cycles. I think the first time I was given the pill I was 14-15. Sadly, I know it was not a very good idea, as it can take years for the period to properly regulate in young girls, but I listened to my doctor. I took it on and off till I was 20. Then at 20 I became sexually active and stayed on the pill without breaks for contraception.
Brief Answer:
About your possible diagnosis:
Detailed Answer:
Hi again,
The history of irregular menstrual cycle supports the diagnosis of PCOS as usually irregular menstrual cycles begins in adolescence in PCOS, but as you have been under contraceptive pills, the cycle has been normal.
Once you stop the pills it has the tendency to come later.
If you are not overweight, there is no sense to check for insulin resistance.
There is no other diagnosis more suitable than PCOS having into consideration your clinical and lab results.
Wishing you good health.
Regards,
Dr.mirjeta
About your possible diagnosis:
Detailed Answer:
Hi again,
The history of irregular menstrual cycle supports the diagnosis of PCOS as usually irregular menstrual cycles begins in adolescence in PCOS, but as you have been under contraceptive pills, the cycle has been normal.
Once you stop the pills it has the tendency to come later.
If you are not overweight, there is no sense to check for insulin resistance.
There is no other diagnosis more suitable than PCOS having into consideration your clinical and lab results.
Wishing you good health.
Regards,
Dr.mirjeta
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. Prasad
Answered by
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