What should I expect?

KelseyBee2014

I'm going to the doctor on Friday and I'm planning on asking her to test me for PCOS. What should I expect? Will she refer me to a gynecologist? Or do a test right than and there?

Deena_Bean

I'm thinking she won't test you on Friday. If she's a general practitioner she may be the one to test, but if she's not comfortable with diagnosing PCOS, she may refer you to a gynecologist. I was diagnosed by my OBGYN via ultrasound.

peabean26

There isn't a one size fits all 'test' for PCOS. For my diagnosis they've done a variety of things to determine that I had PCOS. These things included

1. Patient history- history of missed periods, cystic acne, excess hair growth, etc
2. Ultrasound on ovaries- done during the time of the month when they expect you to be ovulating
3. Full blood panel- includes a 3hr glucose+insulin test

Honestly, even though I was told that I had PCOS by a variety of different gynos over the years, the only time I had #2 and #3 done was recently when I went to a good reproductive endocrinologist and they did a work up on me so I could start fertility treatment.

I wouldn't get your hopes up for a firm diagnosis, even during a gyno appointment. Are you looking to get on Metformin? If so you would probably have to specifically ask for the 3hr blood test to check for insulin resistance in order to get the prescription.

Best of luck!

Dragonwolf

There isn't a one size fits all 'test' for PCOS. For my diagnosis they've done a variety of things to determine that I had PCOS. These things included

1. Patient history- history of missed periods, cystic acne, excess hair growth, etc
2. Ultrasound on ovaries- done during the time of the month when they expect you to be ovulating
3. Full blood panel- includes a 3hr glucose+insulin test

Honestly, even though I was told that I had PCOS by a variety of different gynos over the years, the only time I had #2 and #3 done was recently when I went to a good reproductive endocrinologist and they did a work up on me so I could start fertility treatment.

I wouldn't get your hopes up for a firm diagnosis, even during a gyno appointment. Are you looking to get on Metformin? If so you would probably have to specifically ask for the 3hr blood test to check for insulin resistance in order to get the prescription.

Best of luck!

Even that varies from person to person and country to country.

The only time I ever did the glucose tolerance test (the 3 hour test) was one time when I was pregnant, before I was even diagnosed. I had also been so long without a period that there wasn't really way to determine when I should be ovulating, so that was no basis on getting an ultrasound.

That said, the presence or absence of cysts is not the be-all-end-all of the PCOS diagnosis, OP, so even if that comes up "clean," don't let the doctor tell you that you don't have it by that alone.

Additionally, the blood panel must include your fasting insulin level (especially if the GTT isn't done). This is different from glucose, because glucose is only half of the equation. You can have good glucose levels, but high insulin, and have Metformin work for you. If they don't include fasting insulin, or tell you that the glucose and insulin tests are the same, get a different doctor immediately. Without the insulin check, you have no way of truly knowing whether you're insulin resistant or whether Metformin will or does work for you.

gceaustin

Hi there, I am in medical school (so basically don't take my word for it because I'm not an official MD yet) but from my perspective your doctor will probably refer you to a gynecologist for PCOS related issues. They can probably recommend a great Ob/Gyn in your area.

A few things you should expect:
1. Questions: The gynecologist will probably ask you about your menstrual history, family history, eating habits, exercise routine, etc.
2. Pap & Pelvic exam
3. Imaging (probably not in the office that day) - transvaginal ultrasound. The ultrasound will be a wand-like device that goes into your vagina and the doctor looks for cysts or any abnormalities. I think 'official' PCOS is 12 cysts or more in each ovary or one ovary
4. Blood work: Doc will run a whole bunch of tests, so when you make your appointment, tell them what you are there for and ask if you should be fasting (incase they do any glucose testing)
5. If you do have PCOS, then in most cases they Rx birth control pills and Metformin, they also recommend weight loss, which is the part we all struggle with!

Good luck!

MeepleMuppet

My doctor just took one look at me and knew (she has it too). PCOS is a combination of things that vary from person to person and to varying degrees. If they understand it, they will make sure there aren't larger issues (like insulin resistance), and then probably just start working with you on alleviating symptoms. That's really about all you can "treat", the rest is up to you and your lifestyle choices. They will probably ask you your priorities, what are you most worried about. I was already working on my weight so my doctor and I focused on the facial hair. I am not insulin resistant so my doctor's really only concerned about cancer risk and self esteem.

Edited to say I also don't have cysts. I am a cystless Cyster. PCOS is a misnomer, the history of the term just came up recently in another discussion thread. I wanted to include the link but couldn't find it.

kgibbz

It took years for me to get a dx and my gyno wouldn't even diagnose me. I was referred to an endocrinologist. They did a complete metabolic panel, fasting glucose, testosterone levels and A1C. They didn't do an ultrasound because as another poster said, you dont need to have them to have PCOS. Plus I had an u/s in 2008 and didnt have cysts at the time.

I hope you got some answers today- or at least are heading in the right direction.

My best advice? Dont give up, you know your body best.