What Does This Urine Test Regarding Irregular Periods Indicate?

Brief Answer:
Hello

Detailed Answer:
Hello,
Good day.
May I ask you what was the reason for doing this test? It is important to interpret tests along with patient's clinical details. I presume that this was done as part of work for excess male hormones ? Does the patient have excess acne, hairgrowth in face/chin/chest/thighs etc? How are the periods?

The result shows normal total amount of androgens in urine. However, the androstentriol is slightly on the higher side. This is a metabolite of adrenal androgen DHEA. This probably means that there is slight increase in the DHEA production in adrenal gland which happen in variety of conditions including PCOD, CAH ( congenitral adrenal Hyperplasia) etc. However, the given urine levels are not really high

Regards
Binu

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Brief Answer:
Hello

Detailed Answer:
Hello ,
Good day.
DHEA is a hormone which is produced in ovaries as well as adrenals. So the source of it could be both. In PCOS, most people have excess androgen secretion from ovares. However some people may have androgen production from adrenal as well ( functional adrenal hyperndrogenism). I hope you have seen an endocrinologist and other causes of excess hair growth have been ruled out.

In PCOS, the effective way to reduce hairgrowth and regularise period is to lose weight and exercise. These two surely helps to reduce androgen levels ( by reducing the insulin levels in body. Excess insulin directly influence ovaries to produce excess androgens). Hoever, your levels are not high though.

Next step to control excess hair growth and regularise periods is by using a low dose combined hormone pill. However, it might take up to 6 months for hair growth to reduce ( hair growth cycle is 6-9 months) whilst on hormone pills. In the interim, you may use cosmetic procedures like Laser treatment to get rid of unwanted hairs.

There are some antiandrogens available which may be of use as well. However, an endocrinologist need to examine you and rule out other conditions which can mimic PCOS before starting on these tretment.

I hope your Prolactin test was normal. I have a blog on excess hairgrowth and PCOS in women. Yet to complete it. please visit www.ovarypolycystic.blogspot.in

Kind regards
Binu

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Brief Answer:
Hello

Detailed Answer:
Hello,
Good day.
As i mentioned earlier 3 beta hydroxysteroid dehydroogenase (3beta HSD) deficiency is a type of CAH ( congenital adrenal hyperplasia). In the severe form, blood pressure will be low and there is threat to life as no cortisol is formed. These patients need treatment with hydrocortisone and fludrocortisone life long. Breast size will be small as well. However, a partial ( mild) form of 3beta HSD is a possibility eventhough rare.

I would feel that a partial 21 hydroxylase deficiency type CAH is more common.If you check your blood 17 hydroxy progesterone on 3rd day of periods ( on empty stomach in the morning), that would give an idea.

I do see many of young girls with this form of CAH with severe hair growth, irregular periods etc. SOme women will have clitoris enlargement and excess libido due to excessive male hormone production.

Treatment is a combination of weight loss, exercise, and drugs like combned hormonal pills and certain steroids.

Adrenal cancer will cause production of excess hormones and the urine metabolite levels wil be much higher than your level. Hence that is extremely unlikely. Anyway, please get a scan done to clear your doubt.

I hope i answered your question. You are welcome to ask more questions. If you feel there is nothing more to ask, you may please close the query.

Wish you good health

Knd Regards
Binu

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