Menstrual Irregularities and Hormonal Testing Results

Menstrual issues

1.
Hello Doctor, a few days ago I had blood tests for AMH, LH, E2, and FSH.
The doctor mentioned that it is not necessary to have the blood drawn on the third day of the menstrual cycle.
What period do they use to make their assessments? Is this correct?
2.
On the second day after my period, I had my blood drawn with the following results: AMH: 12.24, FSH: 27.5, LH: 11.3, E2: 53.1.
The doctor said that these values suggest polycystic ovary syndrome (PCOS).
Is this accurate? I also had an ultrasound done a year ago.

3.
I have irregular menstrual cycles, sometimes occurring every two months and sometimes every two weeks.
Does this indicate a polycystic phenomenon?

Y, 20~29 year old female. Ask Date: 2021/03/09

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the diagnostic criteria for Polycystic Ovary Syndrome (PCOS) primarily include the following items: (1) reduced or absent ovulation; (2) elevated levels of androgens either clinically (physical signs) or in blood tests; (3) ultrasound findings of polycystic ovaries; and the exclusion of other causes (such as congenital adrenal hyperplasia, androgen-secreting tumors, and Cushing's syndrome).
It is not solely based on blood tests.
Thank you! Wishing you peace and health, Dr.
Chang.

Reply Date: 2021/03/09

More Info

Understanding menstrual irregularities and the implications of hormonal testing results can be complex, particularly when considering conditions such as Polycystic Ovary Syndrome (PCOS). Let's break down your questions and the associated hormonal values to provide clarity.

1. Timing of Hormonal Testing: It is common practice to perform certain hormonal tests at specific times during the menstrual cycle, particularly for hormones like FSH (Follicle Stimulating Hormone) and LH (Luteinizing Hormone). Traditionally, FSH and LH are measured on cycle day 3, as this is when the hormone levels are relatively stable and can provide a clearer picture of ovarian reserve and function. However, many clinicians understand that not all patients have regular cycles, and testing can be done at other times if necessary. Your doctor’s flexibility in timing suggests they are considering your individual circumstances, which is appropriate.

2. Interpreting Your Hormonal Values: Your results show the following:
- AMH (Anti-Müllerian Hormone): 12.24 ng/mL
- FSH: 27.5 mIU/mL
- LH: 11.3 mIU/mL
- E2 (Estradiol): 53.1 pg/mL
High AMH levels (typically above 4 ng/mL) can indicate a higher number of follicles, which is often seen in women with PCOS. Your elevated FSH level (normal range is generally 4.7-21.5 mIU/mL) suggests that your body may be trying to stimulate the ovaries more than usual, which can be a response to irregular ovulation or diminished ovarian reserve. The LH level is also relevant, as a higher LH relative to FSH can be indicative of PCOS. The estradiol level appears to be within a reasonable range for the follicular phase of the cycle, but the overall hormonal profile does suggest a potential for PCOS.

3. Menstrual Irregularities: Irregular menstrual cycles, such as having periods every two weeks or every two months, are characteristic of PCOS. This condition is often associated with anovulation (lack of ovulation), which can lead to irregular periods. The hormonal imbalance you are experiencing, along with the irregular cycles, supports the possibility of PCOS.

In summary, your hormonal testing results, combined with your menstrual irregularities, suggest that you may be experiencing PCOS. It is essential to discuss these findings with your healthcare provider, who can provide a comprehensive evaluation and discuss potential treatment options. Treatment may include lifestyle modifications, hormonal contraceptives to regulate cycles, or medications to manage symptoms such as insulin resistance, which is often associated with PCOS.

If you have any further questions or concerns, please feel free to reach out to your healthcare provider for personalized advice and management strategies tailored to your specific situation.

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