PCOS treatment

[Anonymous]

I think for “lean Pcos” the diagnosis largely relies on the lh to fsh ratio (in the context of very irregular periods.) has she had those?

[Anonymous]

Op - Ratio is 2.2

[Anonymous]

Anonymous wrote:Op - Ratio is 2.2

That is typical of Pcos. I have had “lean Pcos” since 15, diagnosed at 25 and have been on metformin ever since (except during pregnancies, for which I did need to so iui and ivf.)

at the time I was diagnosed the rec was for metformin even with no indicators of insulin resistance because the rate of diabetes is very high even in lean Pcos.

Definitely wish I didn’t have it but it hasn’t been a huge deal. Good luck to you daughter!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Metformin is a standard treatment.

Not for everyone.
I'm the PP who was officially diagnosed in my early 30s but symptomatic as far back as my late teens. Because I am not insulin resistant (thin, no issues with blood sugar or A1C), none of the doctors I've seen (PCP, endocrinologist, OBGYN, or RE) would put me on metformin.
Combo bc was the best for me at controlling symptoms.

I didn't have any of those issues either and my OB/GYN put me on the meds in my 20s. Helped a lot with excess androgen in particular, and was essential for balancing hormones and for conception. Was thrilled to get off the pill, forever. I never tolerated it well.

I took metformin off and on, did help. A low carb diet helped just as much.

+1 Metformin. I'm surprised she was dx without an ultrasound of her ovaries.

[Anonymous]

Op ultrasound was normal. Glucose/A1c also normal - metformin still the recommendation?

[Anonymous]

Anonymous wrote:Op ultrasound was normal. Glucose/A1c also normal - metformin still the recommendation?

I’m confused as to how PCOS was the diagnosis based on those test results.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Op ultrasound was normal. Glucose/A1c also normal - metformin still the recommendation?

I’m confused as to how PCOS was the diagnosis based on those test results.

PCOS wasn’t diagnosed. OP follower up later and just said the doctor recommended BC to help with periods. Her daughter needs to see an endocrinologist as there is a multitude of reasons for missing periods that is not PCOS. And if it is PCOS and endo should still be seen.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Op ultrasound was normal. Glucose/A1c also normal - metformin still the recommendation?

I’m confused as to how PCOS was the diagnosis based on those test results.

PCOS wasn’t diagnosed. OP follower up later and just said the doctor recommended BC to help with periods. Her daughter needs to see an endocrinologist as there is a multitude of reasons for missing periods that is not PCOS. And if it is PCOS and endo should still be seen.

Thank you, that makes much more sense.

[Anonymous]

Op here, thank you, everyone. Waitlist to see an endo here is into the summer of 2026. Only recourse is to go back to gyn for now, I think dr will push for the pill

[Anonymous]

Anonymous wrote:Op here, thank you, everyone. Waitlist to see an endo here is into the summer of 2026. Only recourse is to go back to gyn for now, I think dr will push for the pill

Are you in a remote area? In DC it’s about 3 months.

[Anonymous]

Not remote but busy burb

[Anonymous]

Anonymous wrote:Not remote but busy burb

I would look across the DC Metro area before continuing to treat as the Gyn recommends. She needs to see the specialist for this condition.

[Anonymous]

Anonymous wrote:Op here, thank you, everyone. Waitlist to see an endo here is into the summer of 2026. Only recourse is to go back to gyn for now, I think dr will push for the pill

Ask for full thyroid panel and a check of prolactin level, as well. You can at least get that without needing to go to an endocrinologist.

[Anonymous]

Thanks. Thyroid and prolactin normal - in fact everything normal except free testosterone is high and LHR/fsh is 2.2

[Anonymous]

Intermittent fasting has controlled almost all of my pcos issues. YMMV. And I’m not some IF proselytizer that says it cures all but it really did make a huge difference.