Prescribed Metformin For PCOS. Done Blood Test. Is The Result Enough To Support Diagnosis?

Posted on Mon, 10 Sep 2012

Question: I am 37 yo, with a 5 weeks menstrual cycle. I am slim overall, jog for 20 mins everyday. 155cm, 50kg but always has a little tummy. I went to see a local gynaecologist. She performed trans-vaginal ultrasound for me. There was no cyst inside. But she said that I have PCOS and prescribed Metformin 500mg tds for me. Today I got the blood result: Prolactin 14.2ng/ml, FSH 2.1 mIU/ml, LH 4.9 mIL/ml, Estradiol 144.7 pg/ml, TSH 1.13. Is that blood result enough to support the diagnosis?
Moreover, I had a HPV DNA screening, which showed that HPV subtypes 70, 16 were detected. What does it mean? Do I have a high risk of getting carcinoma?
My mammogram report showed that I have fibroadenosis, BI-RADS, Category 2. And the gynaecologist suggested me to take regular E.P.O. Is that really helpful?

Answered by Dr. Monika Choudhary (2 hours later)

Hi,
Thanks for posting your query.
I have gone through your blood test reports.
Level of serum prolactin & TSH are within normal range, ratio of LH:FSH slightly points towards PCOS.
Your weight is within normal range.
The main thing to do is to regularly exercise & maintain your weight. Also continue the medication as prescribed by your Gynaecologist.
Regarding HPV 70,16 positive-To be positive for HPV increases risk of getting cervical carcinoma. So get a Pap smear done yearly to screen for cervical cancer.
Fibroadenosis is a benign lesion. Whether evening primrose oil (E.P.O) is really helpful or not, is not proven, but it may help & you can continue it for 3-4 months. if it does not get cured, you can think about a surgery.
Let me know if you have any more concerns.
Thank You.

Above answer was peer-reviewed by : Dr. Aparna Kohli

Follow up: Dr. Monika Choudhary (22 hours later)

Thanks Dr Choudhary!

May I know if it is necessary to take more blood test to further confirm the diagnosis? Do I need to take Metformin for life long?

How often should I repeat the mammogram in my case?

I had the HPV vaccination 2 years ago after getting a normal Pap Smear report. So now I have the HPV 70 and 16 +ve, does it means that the vaccination was not useful for me? Will it be helpful if i get another HPV vaccination from another brand?

Thanks a lot!

Answered by Dr. Monika Choudhary (1 hour later)

Hi,
Thanks for writing back.
Please get your random blood sugar test done.
If blood sugar remains within normal range & periods remain regular,then there is no need to take metformin.
In your case,mammogram should be repeated at six months interval till two years.
HPV vaccination is most effective between 9-18 years of age. Vaccination can prevent,but does not cure the disease. Sometimes there is possibility that you are HPV positive with normal pap smear.
So repeat your pap smear & go through colposcopy.
If these investigations remain normal, repeat pap smear yearly.
I hope your query has been answered.
Regards

Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Aparna Kohli