Doctors willing to diagnose PCOS in Virginia

pamplemousse21

Hi all! I have had the worst time with doctors on my PCOS journey. I’m sure many of you can relate. Most of my doctors haven’t believed me that my rapid and extreme weight gain was not accompanied with binges, bad eating, and lack of exercise. I ate health consciously through my undergraduate years and still gained 150 pounds in 5 years. They have lectured me condescendingly on the absolute basics of healthy eating (eg. you do know that asparagus is better for you than cheez it’s, right?). Writing in my chart that I have a binge eating disorder when I explicitly told them that I don’t have a problem with this. Not believing me when I tell them I’ve never been hospitalized for blood clots. Ignoring abnormalities in my blood tests that would indicate a possibility of PCOS. Etc etc.

My last doctor told me that I probably do have PCOS and that it was important for me to lose the weight but that my current method of losing the weight (low carb) wasn’t going to keep working. When I asked her if metformin would help she told me yes but then when I asked if I could get a prescription she dodged the question and said we will see at your next appointment (a year from now). She is perfectly able to prescribe it and I have no other medical concerns that would discourage her from doing so.

I have lost 40 pounds on low carb after not being able to lose weight for 5 years no matter what I tried. I’ve also been getting fewer migraines, less ovarian pain, more regular periods, less acne, less fatigue, and my depression and anxiety have gotten better. However recently my weight loss has completely halted and these other symptoms are coming back slowly with no change to my diet. I still have plenty of weight to lose (over 100 pounds to the “healthy” range).

All of this to say, has anyone been diagnosed and prescribed metformin by a doctor in the Charlottesville, VA area? I would be willing to drive 2+ hours to see someone who I know would take me seriously and help me solve this, so any suggestions in Virginia, Maryland, DC, northern North Carolina, or eastern West Virginia would be appreciated. I’ve been wasting so much money on doctors who don’t help and it’s very frustrating and depressing to get your hopes up and have another doctor not take you seriously.

Edit: I have been doing everything I can to break through this plateau. Recalculating calories, more water, less sodium, more exercise, etc. I recognize that this could just be a general weight loss plateau that will go away but what concerns me is that it is accompanied by an increase in all of my other PCOS symptoms. Thank you for the tips, but I am in fact on top of that.

lowcarbmale

pamplemousse21 wrote: »

I have lost 40 pounds on low carb after not being able to lose weight for 5 years no matter what I tried.

nice

tinkerbellang83

pamplemousse21 wrote: »

However recently my weight loss has completely halted and these other symptoms are coming back slowly with no change to my diet. I still have plenty of weight to lose (over 100 pounds to the “healthy” range).

Are you maintaining a calorie deficit? You mention healthy eating and low carb but not calories.

Regardless of your PCOS, it does still come down to maintaining a calorie deficit.

Check out some of the threads in the Success Stories board

https://community.myfitnesspal.com/en/discussion/10366061/pcos-success-with-weightloss/p1

https://community.myfitnesspal.com/en/discussion/10533007/from-dieting-to-a-lifestyle-change-inspired-by-my-future-with-pictures/p1

cathipa

If you've lost 40 pounds being low carb why did the physician say it wasn't going to work long term? Are you exercising as well? Why are you looking to get on metformin so badly if you are currently losing without medications? Medications aren't without side effects.

pamplemousse21

Because when you have PCOS it is much harder to lose weight. I want metformin because I have a condition that metformin can help. There is nothing wrong with going on a medication that will help your body function as it should. Also it would be super rad if one day I wasn’t infertile which metformin can help. And the drop in weight that metformin will help with (that I may or may not be able to accomplish on my own, no matter how hard I work at it because PCOS makes your body function differently) will decrease my 3 migraines a week, debilitating ovary pain, and excruciatingly painful cystic acne. It’s fine if it’s not the choice that you would make but metformin is not some hydroxycut unsafe weight loss drug. It will help my body and my insulin function as it should so I am pursuing it. There’s no harm in pursuing medication that can help my body.

apullum

Metformin does not cause weight loss on its own. I was obese before metformin, and I was obese while on metformin. Metformin can help with some specific problems that are related to PCOS. For me, metformin was necessary to lower my lipids, which did not respond to statins alone. It also helps restore some people’s ovulation cycles. But if you don’t have a specific need for it, then I can see why your doctor didn’t want to prescribe it.

You don’t mention anything about your calorie intake or how you are measuring your food. Weight loss with PCOS still happens when you eat fewer calories than your body burns. It may just happen a bit more slowly than expected. What is your calorie goal, and are you weighing all your food?

A low carb diet may help PCOS symptoms but does not cause weight loss on its own. None of the other things you mentioned—eating “healthy,” drinking water, less sodium, etc.—cause weight loss. Exercise does not cause weight loss unless it contributes to a calorie deficit. Weight loss happens when you eat fewer calories than you burn. The best way to ensure that you’re doing this is to weigh all your food.

pamplemousse21

I am not looking to metformin to be a magic wand. I know multiple people who have used it and it has helped them lose weight with a healthy diet and calorie deficit. I am perfectly willing to put in the work and have seen metformin make it so that people don’t have to work twice as hard to achieve 1/2 the results. I know this doesn’t happen for everyone but it has happened for multiple people I know and is supported by studies, though they don’t know why some people lose weight on metformin. As stated before, even if metformin doesn’t help me lose weight, i would want to try it because I would like to have a normal ovulation cycle so that hopefully my ovaries some day aren’t just useless piles of pain.

I am in a calorie deficit calculated to lose 2 pounds a week. Those things i mentioned are all useful for breaking through a weight loss plateau if that plateau is caused by water weight, which is why I mentioned them.

ahamm002

PCOS does not break the laws of physics. Your body needs to burn a lot of calories every day to keep you alive. If you eat less calories than your body is burning you will lose weight regardless of hormones.

It sounds like you have this dream that if you can just get on metformin you'll lose weight and everything will work out. Unfortunately nothing is ever that easy. Diets (espcially restrictive ones) often stall out. You just have to really log your food carefully, and try and implement permanent lifestyle changes a bit at time.

tinkerbellang83

pamplemousse21 wrote: »

I am in a calorie deficit calculated to lose 2 pounds a week. Those things i mentioned are all useful for breaking through a weight loss plateau if that plateau is caused by water weight, which is why I mentioned them.

How long has it been since you have lost weight?

and how are you determining your calorie intake are you guesstimating, measuring with cups or weighing?

seska422

pamplemousse21 wrote: »

Most of my doctors haven’t believed me that my rapid and extreme weight gain was not accompanied with binges, bad eating, and lack of exercise. I ate health consciously through my undergraduate years and still gained 150 pounds in 5 years.

I've been in a similar situation. I once gained ~150 pounds in ~15 months.

Are you grazing (eating something every one to two hours)? How big are your portion sizes?

You can pack a lot of calories into what honestly feels like (and looks to observers like) normal eating.

Logging can really help with figuring out where calories are coming from so that you can shave away much of the excess without really impacting the basics of what you are eating. You can basically eat what you normally eat but eat less of the calorie-dense foods and more of the non-calorie-dense foods. Think of calories like money. Log before you consume so that you don't forget and so that you can decide if you really want to spend those calories and, if so, how many you want to spend and adjust your portion size based upon that. Also, try to find calorie-free drinks that you like if you are drinking some of your calories.

MelanieCN77

This baffles me. Searching for a doctor who will do what you have decided is right rather than taking the hint from the many you've seen?

apullum

pamplemousse21 wrote: »

I am not looking to metformin to be a magic wand. I know multiple people who have used it and it has helped them lose weight with a healthy diet and calorie deficit. I am perfectly willing to put in the work and have seen metformin make it so that people don’t have to work twice as hard to achieve 1/2 the results. I know this doesn’t happen for everyone but it has happened for multiple people I know and is supported by studies, though they don’t know why some people lose weight on metformin. As stated before, even if metformin doesn’t help me lose weight, i would want to try it because I would like to have a normal ovulation cycle so that hopefully my ovaries some day aren’t just useless piles of pain.

I am in a calorie deficit calculated to lose 2 pounds a week. Those things i mentioned are all useful for breaking through a weight loss plateau if that plateau is caused by water weight, which is why I mentioned them.

Do you have some reason to believe your plateau is caused by water weight? And is your goal to lose water, or to lose fat? If you want to lose fat, then no, none of the things you mentioned will help.

You still don’t mention whether or not you’re weighing your food. Plateaus are most often caused by unintentionally eating at maintenance due to errors in logging food and/or exercise.

happytree923

Afaik metformin does not help or hinder weight loss. Honestly, I think you need to relax, let go of the PCOS self-diagnosis for a little while, and focus on continuing a calorie deficit and logging accurately using a food scale etc. as others have suggested. You've already lost 40 pounds and found that your symptoms improve, that's great! It sounds like your doctor just wants to revisit at a later date because your symptoms might go away with more weight loss, which imo is a sign of a good doctor not loading you up on medications and giving you a diagnosis that may not be accurate.

cathipa

pamplemousse21 wrote: »

Because when you have PCOS it is much harder to lose weight. I want metformin because I have a condition that metformin can help. There is nothing wrong with going on a medication that will help your body function as it should. Also it would be super rad if one day I wasn’t infertile which metformin can help. And the drop in weight that metformin will help with (that I may or may not be able to accomplish on my own, no matter how hard I work at it because PCOS makes your body function differently) will decrease my 3 migraines a week, debilitating ovary pain, and excruciatingly painful cystic acne. It’s fine if it’s not the choice that you would make but metformin is not some hydroxycut unsafe weight loss drug. It will help my body and my insulin function as it should so I am pursuing it. There’s no harm in pursuing medication that can help my body.

I have PCOS and while it may be more difficult I was able to do it without ever taking medication. Metformin should be saved in cases where fertility is compromised and you are actively trying to get pregnant.

cwolfman13

Do you get an annual physical? Every doctor I've ever been to does blood work as part of an annual physical and that's where they would start with a PCOS diagnosis...namely your androgen levels would be elevated. If you've had blood work done and you don't have elevated androgen levels, there really wouldn't be any reason to go through with further testing. I think you're just self diagnosing based on the fact that weight loss can be difficult.

me0231

I hear you. PCOS really blows. Can you ask your doctor for a referral to an endocrinologist? Maybe there is one close to you. Sorry I don't know the area. Having a proper diagnosis from a specialist will help in getting the treatment you need. Hashimoto is somewhat common with PCOS too so make sure your thyroid levels are checked.

Also just anecdotally I had to go quite a bit lower in calories than what would have been expected for my weight and height to lose. Work with a dietician if you can and ignore the Google warriors and know it alls. Good luck!

kshama2001

My friend with PCOS is very happy with her endocrinologist, so getting a referral to one of those would be something to look into.

Never the less, my understanding is that women with PCOS may need a few hundred less calories than women without it, so it still just comes down to a calorie deficit.

There are mistakes that people commonly make that cause them to not lose weight that we might be able to spot if you change your Diary Sharing settings to Public: http://www.myfitnesspal.com/account/diary_settings

pamplemousse21

God. I thought posting on MyFitnessPal would be fine but apparently the internet is trash everywhere. Thanks to those of you who actually said helpful things instead of assuming I was lazy and wanted metformin as a magical solution. And to be clear, i have been diagnosed but the doctor didnt do or suggest anything helpful (my title maybe makes this unclear, thats on me). I am not self diagnosing. I am counting calories meticulously (including weighing/measuring my food). I just want a doctor who believes me when I outline my symptoms and provides some sort of solution instead of “you aren’t going to be able to keep losing weight but you have to to be healthy” or just writes binge eater down in my chart when I explicitly told them I’m not. If they had some sort of solution other than metformin I would be perfectly happy with that (prescription or otherwise) but no one has done so.

cathipa

pamplemousse21 wrote: »

God. I thought posting on MyFitnessPal would be fine but apparently the internet is trash everywhere. Thanks to those of you who actually said helpful things instead of assuming I was lazy and wanted metformin as a magical solution. And to be clear, i have been diagnosed but the doctor didnt do or suggest anything helpful (my title maybe makes this unclear, thats on me). I am not self diagnosing. I am counting calories meticulously (including weighing/measuring my food). I just want a doctor who believes me when I outline my symptoms and provides some sort of solution instead of “you aren’t going to be able to keep losing weight but you have to to be healthy” or just writes binge eater down in my chart when I explicitly told them I’m not. If they had some sort of solution other than metformin I would be perfectly happy with that (prescription or otherwise) but no one has done so.

If you are looking for a doctor then search on healthgrades.com

CharlieBeansmomTracey

pamplemousse21 wrote: »

God. I thought posting on MyFitnessPal would be fine but apparently the internet is trash everywhere. Thanks to those of you who actually said helpful things instead of assuming I was lazy and wanted metformin as a magical solution. And to be clear, i have been diagnosed but the doctor didnt do or suggest anything helpful (my title maybe makes this unclear, thats on me). I am not self diagnosing. I am counting calories meticulously (including weighing/measuring my food). I just want a doctor who believes me when I outline my symptoms and provides some sort of solution instead of “you aren’t going to be able to keep losing weight but you have to to be healthy” or just writes binge eater down in my chart when I explicitly told them I’m not. If they had some sort of solution other than metformin I would be perfectly happy with that (prescription or otherwise) but no one has done so.

if you are measuring solids and semi solids then that could be the issue right there. as measuring cups are inaccurate for those things.if you have stopped losing for any length of time then the measuring cups can be the culprit. (it was for me and then I started to gain weight back. I dont have PCOS but have other health issues). i9f you had blood tests done and the dr said you do ave PCOS then he/she needs to make you a referral to and endocrinologist. maybe your primary dr wont prescribe meds like metformin unless she/he thinks they are necessary.

I live in wv and you can forget drs prescribing metformin either. they will refer you to an endo if they deem it necessary and not all endos will prescribe it either. my sons gf has endo and many other issues and none of her drs have prescribed metformin. they told her that IF her prediabetes became diabetes then they may prescribe it but they told her to try and lose the weight on her own first. same with my daughters endo. she has a thyroid issue but no PCOS,no IR,no pre diabetes and she too told her to try and lose the weight on her own first as she doesnt like to prescribe meds that may not be necessary and she will only prescribe certain meds if needed. of course my daughter needs thryoid meds so she is on them.she is very overweight and her endo just told her to be more active and try to eat as well as she can,but for her she has to get her thyroid levels up to par first.


if your drs think you are a binge eater and you are not its time to find another dr and go from there. if a dr isnt willing to listen then its time to move on. good luck getting any dr to prescribe metformin unless they think its necessary. many I know that have pcos go to the gym and lift and become more active which helps them. I dont know one of them who takes or has taken metformin. not to say there arent women out there that do take it,because there are.

jemhh

PCOS does not cause a person to gain 150 lbs in 5 years. Eating too much does that. Averaged out, that's about 300 calories too much per day for 5 years. Before you get all "you don't even know!", keep in mind that I have PCOS. Continue eating low carb if that helps you as it seems to be. Metformin can help with weight loss as it tends to reduce hunger a bit, but it can also be accompanied by gastrointestinal side effects. It's a trade off. I was taking it in order to help with ovulation, not for weight loss, and once I didn't care as much about my ovulation I went off as the side effects weren't worth it for me. Regardless, you can lose weight without it, as you've already proven.

brightsideofpink

I have PCOS. I'm happy to share with you my story and how it relates or doesn't relate to weight loss. I was struggling with infertility and successful pregnancy, having suffered 7 miscarriages in 7 pregnancies in 6 years. I started to see a gynecologist who specializes in oncology. They diagnosed my PCOS (didn't know I had it) via ultrasound. The very definition of PCOS is that you have multiple cysts on your ovaries, something easier to see than detect in blood. I started metformin. I was not actively looking to lose weight at the time, and did not lose weight while I was on it. I stopped metformin with a successful pregnancy (he's 6 now and super cool).

I still have PCOS. I don't take metformin. Yes, my calorie limit is adjusted for that because I do believe it affects my BMR. But I was still able to lose 70 lbs without medication.

My advice, I guess, would be 1) see a gynecologist for an ultrasound to determine if you have PCOS. 2) get your BMR tested to determine what your CO portion of the equation really is.

Best of luck.

apullum

pamplemousse21 wrote: »

God. I thought posting on MyFitnessPal would be fine but apparently the internet is trash everywhere. Thanks to those of you who actually said helpful things instead of assuming I was lazy and wanted metformin as a magical solution. And to be clear, i have been diagnosed but the doctor didnt do or suggest anything helpful (my title maybe makes this unclear, thats on me). I am not self diagnosing. I am counting calories meticulously (including weighing/measuring my food). I just want a doctor who believes me when I outline my symptoms and provides some sort of solution instead of “you aren’t going to be able to keep losing weight but you have to to be healthy” or just writes binge eater down in my chart when I explicitly told them I’m not. If they had some sort of solution other than metformin I would be perfectly happy with that (prescription or otherwise) but no one has done so.

No one said you were lazy. No one said you were self diagnosing. And I'm not sure why any of this conversation demonstrates that "the internet is trash." Most people have given you accurate advice, and many of us have been in similar situations.

I have (had?) PCOS and was morbidly obese. I was on metformin along with several other medications. I took metformin for many years with no change in my weight, even though I was active and eating a healthy diet. I lost weight when I started accurately weighing and logging my food, and consistently staying within my calorie goal. Once I was about halfway to my goal weight, I was able to stop all the medications. After losing 100 pounds, I am now at an optimal BMI, where I have been maintaining for over a year. I continue to manage my medical conditions without medication.

me0231

brightsideofpink wrote: »

I have PCOS. I'm happy to share with you my story and how it relates or doesn't relate to weight loss. I was struggling with infertility and successful pregnancy, having suffered 7 miscarriages in 7 pregnancies in 6 years. I started to see a gynecologist who specializes in oncology. They diagnosed my PCOS (didn't know I had it) via ultrasound. The very definition of PCOS is that you have multiple cysts on your ovaries, something easier to see than detect in blood. I started metformin. I was not actively looking to lose weight at the time, and did not lose weight while I was on it. I stopped metformin with a successful pregnancy (he's 6 now and super cool).

I still have PCOS. I don't take metformin. Yes, my calorie limit is adjusted for that because I do believe it affects my BMR. But I was still able to lose 70 lbs without medication.

My advice, I guess, would be 1) see a gynecologist for an ultrasound to determine if you have PCOS. 2) get your BMR tested to determine what your CO portion of the equation really is.

Best of luck.

Just wanted to add that you don't need cysts to have PCOS despite its name. It's an endocrine disorder that can cause cysts but it's not a requirement for diagnosis ( that's why a hysterectomy doesn't fix pcos).

pamplemousse21

Multiple people explicitly said I was self diagnosing. Multiple people implied I was lazy by saying I was looking for a magical solution. I’ve been doing the work and I made this post because I’m sick of doctors assuming I haven’t and the last thing I wanted was people who do not know the condition telling me that I haven’t. There has been plenty of good advice that I plan to use. I didn’t realize how inaccurate measuring cups can be for example. But there has been too many annoying comments about me looking for a magical solution (I.e. looking for a doctor who will explore solutions for my already diagnosed PCOS instead of telling me I’m doomed to not lose the weight) or me just self diagnosing that I’m done looking at and responding to this. I really am grateful for those who tried to help and did help but I came here explicitly for the reason of seeing if I could find a doctor who would listen to me, not so that people could condescend to me about my situation (again, explicitly talking about people saying I’m self diagnosing or looking for a magical solution, not the people who tried to help but were giving me information I already knew).

pamplemousse21

MelanieCN77 wrote: »

This baffles me. Searching for a doctor who will do what you have decided is right rather than taking the hint from the many you've seen?

Right. How obscene of me to want to find a doctor who cares about my excruciating ovary pain, frequent migraines, constant fatigue, and extremely painful cystic acne instead of just telling me I have PCOS and am doomed when I know there are things that can help.

cmriverside

Why don't you try suing for malpractice? That seems to be the angle you are taking. There's more to this story and you just aren't telling it all. There is no way I believe that multiple doctors are refusing to treat a diagnosed condition. That just doesn't make sense in this litigious society.

Heck, I have the opposite problem. If I mention any kind of symptoms of anything at all they want to give me multiple tests and pills.

I have never had a problem getting medication for a diagnosed illness. There's more to this story.

cmriverside

...and you say you know multiple people who have gotten Metformin and that it has helped their exact same problems? Why not ask them who their doctor is?

pamplemousse21

cmriverside wrote: »

...and you say you know multiple people who have gotten Metformin and that it has helped their exact same problems? Why not ask them who their doctor is?

The more to the story is that the first 3 doctors told me there is nothing wrong you are just overeating and not telling us go home and didn’t test me. The fourth doctor told me I do have PCOS and basically told me I’m doomed to deal with the symptoms forever. I didnt feel a need to make an already long post longer by adding those details and didn’t feel the need add those details in general. I was asking for recommendations for doctors, those details aren’t relevant. And because of the three people I know with PCOS 2 were diagnosed in Texas and one was diagnosed in Maine.

CharlieBeansmomTracey

the things with drs is its going to be trial and error. my mother in law when sick saw more than 5 drs for her illness,finally she found one who was able to figure out what her health problem was. she had many tell her one thing and another would tell her no she had something else. by the time she found out what it was it was too late.so it can take dr after dr to figure out the issues and find one that is willing to listen as well.

same with endos. my daughter went to one who did not believe she barely ate 1200 calories,she looked at her like she was an overeater too. she wasnt and still isnt.she told her she had insulin resistance just by looking at her(she had Acanthosis nigricans). she did NO blood tests. made my daughter feel like a piece of *kitten* and belittled her because she was NOT a vegetarian.

we left her practice after that ONE visit. it was that bad and had our family dr find another endo. she finally found one that doesnt belittle her and treats her like a human being and we found out she does not have insulin resistance either and the Acanthosis nigricans cleared up with her thyroid meds. she had no other issues besides that. she can actually talk to her endo and she is helpful.

pamplemousse21

CharlieBeansmomTracey wrote: »

the things with drs is its going to be trial and error. my mother in law when sick saw more than 5 drs for her illness,finally she found one who was able to figure out what her health problem was. she had many tell her one thing and another would tell her no she had something else. by the time she found out what it was it was too late.so it can take dr after dr to figure out the issues and find one that is willing to listen as well.

same with endos. my daughter went to one who did not believe she barely ate 1200 calories,she looked at her like she was an overeater too. she wasnt and still isnt.she told her she had insulin resistance just by looking at her(she had Acanthosis nigricans). she did NO blood tests. made my daughter feel like a piece of *kitten* and belittled her because she was NOT a vegetarian.

we left her practice after that ONE visit. it was that bad and had our family dr find another endo. she finally found one that doesnt belittle her and treats her like a human being and we found out she does not have insulin resistance either and the Acanthosis nigricans cleared up with her thyroid meds. she had no other issues besides that. she can actually talk to her endo and she is helpful.

Thank you so much for both of your very helpful responses.