When I came to US and went to see a doctor for my condition (I even told here I was PCOS), the first thing she did was to order a lot of blood work. I am sure all fertility tests begin with the blood work. Just like everyone, I had no clue what these levels were. Even though there was a chart in the blood work that says the normal value ranges, I was still confused as my levels were either lower or elevated than normal. I couldn’t comprehend what the higher/lower levels meant.

This can be really frustrating because in most cases, doctors also do not really say much about what the lower/higher levels mean. So I started reading on the net and found some answers though not all. In this post, I want to share the details of the normal ranges and what a deviation from normal means.

Ok, there are several vials of blood taken from you on the Day 3 of your cycle. This stage is called the follicular phase and the levels are termed ‘Follicular Phase levels’. Later some more tests are done on Day 7 of your cycle, which is called the mid cycle phase and usually LH is checked at the surge period (Days 13 to 15) to check for ovulation.

These values are the average normal ranges and the ranges may differ from lab to lab. These values are presented just for the reference purposes so that you can better know about the hormone levels and ask your doctor precisely about the doubts that you may have. These values must not be used for self diagnosis or treatment.

There are several other tests that are taken when one goes for a fertility treatment. I am going to write about those tests and what they mean in my future posts.

I hope these info helps at least in a small way.

Have I missed any hormone values? Do you have more information on the hormone levels from your doctor? Please share them in the comments.

Now, the title of this post may have you wondering if this is going to be a replica post to the post about symptoms of PCOS. No, its not. In fact, one of my friend’s question is the main reason why this post is here. She chanced to go through my blog and started wondering if she had PCOS because in her words “3 of the symptoms do match”. To be honest I was taken aback and also thought how many women who are TTC (trying to conceive) might get a skewed perception by reading through the symptoms. So I thought, it would do more good to have a post on clarifying that point.

So here goes the list of points to consider before thinking that you might have PCOS too:

1. Acne: Don’t go thinking  “Am I PCOS?” if you got a pimple because you have your periods around the corner or if you had an exciting evening and went to bed forgetting to take your make up off. Trust me, PCOS acne is far worse than that, there is no reason why that pimple would come and that too in groups (instead of that cute single pimple on the cheek) and most importantly never take the name of leaving your face whatever you do about it. Having a pimple or two is not an acne issue.
2. Facial Hair: Most of the girls have small and very fine hair in the upper lip and lower lip regions and they are not visible and are definitely not an eye sore even if it is not removed. If you have PCOS, and if you are one of the unlucky few like me to have this symptom, the hair in these areas are not the fine cat hairs. They are dark and thick and the it is truly agonizing that it must be removed regularly to go out without embarrassment.
3. Mood Swings: It is absolutely normal if you have mood swings just 2 days before the periods or sometimes during ovulation too (around the mid of your regular cycle). These are not the mood swings that I am talking about in the symptoms. Ask yourself if you ever felt depressed so much that you started crying for no reason at all?? Had you ever had the experience of being so happy in the morning and going to bed crying in the night? That's the mood swing I am talking about. In my case, sometime I get depressed for no reason at all and later stay sad the whole day getting only negative waves.
4. Irregular Cycle: Some girls think their cycles are getting irregular when they miss an odd period or if they cycle started a week earlier (for ex: anxiety can cause an early period) once in a blue moon. FYI, those are not at all symptoms of PCOS! In PCOS condition, one would have lesser than 8 periods in an year with no/very less cramps and very little bleeding or have more than 15 periods in an year bleeding as if thats never going to stop ever.

You can find an excellent PCOS self test questionnaire here. If you have serious doubts, you could try filling this questionnaire up. But the best thing to do is to visit a doctor. Never come to conclusions on your own and don’t get medication ideas from your PCOS friends. A qualified doctor is the only person who can say if you do/don’t have PCOS and even if you conclude that you have PCOS from the self-test questionnaire, don’t do any self medication because the treatment for this may also differ based on your need (like TTC, not sexually active or sexually active but not planning to conceive) and based on your differing symptoms (few may not be insulin resistant as in the case of 70% of PCOS women and may not need diabetic drug).

I think this post is going to be useful not just for women with PCOS but also for the mothers whose daughters are at the puberty stage. I am saying this because the symptoms start appearing in their mid teens and that is the best time to start treating this as it could be controlled way too effectively if it were to be treated at an early stage.

What are the changes that indicate PCOS?

• The first and the most visible – ACNE. Yes, most teenagers who have PCOS have bad cases of Acne which trust me, does not respond to anything on this earth :(  These acne outbreaks come without any regularity (I mean some girls get a pimple or two just before their monthly cycle – but the PCOS one gets them anytime).
• The second predominant symptom is the unwanted facial hair – again no permanent solution for this. Some people may also have hair growth in chest and stomach areas. Frustratingly accompanied with loss of hair in scalp.
• Abnormal weight gain or weight loss – That’s yet another strange thing about PCOS. Anything on the either side of normal signals PCOS.
• Irregular menstrual cycles – Again as is the case with PCOS, this might be lesser than 9 periods in a year with very less bleeding or more periods with very heavy bleeding.
• Mood swings – Mostly this is depression. This might be less noticeable in young girls but becomes a greater problem with women.
• In most cases, the syndrome is diagnosed only when there is a fertility issue. So I can also add Infertility or Fertility problems as one of the symptoms.

Is PCOS Hereditary?

Yes it is. Unlike one might think, one can get this syndrome if it ran in either of the parent’s family.  But that is just one thing. There are several other reasons why the hormone levels are not normal like environmental factors, dietary factors, etc. So if you have a doubt, start with checking if other women in the family have irregular periods, diabetes or fertility problems.

What are the diagnostics?

Be prepared to be embarrassed with questions and diagnostics when you go to a doctor for the first time for PCOS. I am sure none of us would ever forget our first visit and the questions that we had to answer for. But trust me, this will all sound just like regular discussion after a couple of visits to your doctor. So here’s what they ask/do:

1. Questions on hereditary factors like anyone else in family with PCOS and stuff
2. Questions on previous medical conditions and health in general
3. Physical examination of the body – to check for unwanted hair growth
4. Lot of blood work – to test for various hormone levels and to overrule other problems like thyroid/gland problems as they have similar symptoms.
5. In most cases, a scan or ultrasound which could be either pelvic or trans-vaginal. This not only confirms the PCOS but also helps the doc to make sure that you don't have any other major issues.

So what are the treatment?

The first thing that the doc would say if you are on the higher side of weight levels is to reduce the weight. Regular exercise and diet plans are the first step recommended (if ever you met a good doctor). Otherwise, the docs prescribe a medicine called Metformin – a  diabetes drug and birth control pills to regulate the periods or fertility medicine if you are trying to get pregnant. Some doctors suggest some kind of Acne soaps, astringents or creams for acne, but from my experience, they don’t work at all :(  So the best thing to do is stop being conscious and DO NOT pick the acne as they leave a scar which is again not easy to get rid of. For the unwanted facial hair, tweezing, threading or waxing are temporary solutions. I tried 4 sittings of laser and that didn’t work for me and am back to waxing now. Not sure how far permanent electrolysis is. But these are costly and painful alternatives.