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ImNotHere's avatar

PCOS Or Could It Be Something Else?

Asked by ImNotHere (441 points ) September 3rd, 2011

Hey Jellies,

I’m a 21 year old female who’s been fortunate enough to enjoy what even my doctors call ‘excellent health’. Except for struggling with my weight for a couple of years in middle school/high school due to a high carb diet and a sedentary lifestyle, I’ve always been in-shape and attractive. (So I’ve been told.)

With lifestyle changes and moving to image-conscious NYC, my weight has remained stably healthy and according to most people who know me, I look better than ever. Because of this, I should feel good about myself but I can’t because in recent years I’ve developed a problem that might be even worse than being fat…

I’ve noticed that some of my body and facial hair seems to be becoming progressively more prominent, stiff, and unmanageable. It started when I was about 18, and I started being bothered by a slightly fuzzy dark “happy trail” on my stomach. Not knowing any better, I did one of the stupidest things in my life (no joke) and shaved the damned thing. This turned out to be a very BAD DECISION.

Thanks to the few occasions of shaving the hair 5 years ago, I’m still dealing with the aftermath- believe it or not. Before I shaved, the hair was dark, but still soft. Now it comes in like stiff, black wires and is very prone to becoming ingrown. After I realized that shaving was no good, I decided to tweeze the thing, thinking it would resolve the irritation/stiffness. Nope! Tweezing is just as bad: it leaves pitted scars and hyper-pigmentation on my stomach from ‘digging’ for embedded hairs and they still come in stiff and nasty. I’m constantly having to pull them out by the root but it just irritates my skin more in a vicious cycle that drives me insane. :(

As for my face, I’ve always had some fine, vellus hair that I would wax or tweeze if it seemed too dark or noticeable. But the past couple of years, I’ve noticed that my chin hair is becoming stiffer too. I now have some hairs that come in like men’s stubble that I’m constantly having to tweeze and I’m always paranoid about. Luckily they’re not very noticeable to the naked eye but they still drive me crazy when I can feel them on my fingertips and make me feel so unattractive. Sometimes I get so down even cry about it. :(

This is embarrassing: My pubic hair is becoming thicker too. My bikini line now extends way farther down my thigh than it used to and I’m constantly shaving/waxing to hide this fact from my boyfriend. I’m afraid he would be so grossed out if he knew how disgusting and hairy his “hot” girlfriend really is. :(

For some reason my arm hair is still blonde and fine and my leg hair remains normal. (Thank God!)

I don’t understand why I have this problem. Besides the hair issue, I have very feminine physical characteristics. I only recently discovered on an ER visit for an unrelated issue with an IUD, that I do have an ovarian cyst, like I long suspected I did. (I asked my Dr. to check me for them once and she totally blew me off and disregarded it.)

I’m starting to wonder if this hair thing could be an indicator that I have some kind of PCOS (Polycystic Ovary Syndrome) but the thing is, I don’t have any of the other symptoms. My weight is stable and manageable. I don’t have increased acne or skin tags or random hyper-pigmentation on my face, limbs etc.

As for the hair, I keep playing with the idea of laser hair removal and electrolysis and I’ll probably end up doing it in the near future, but I really want to get to the bottom of what’s causing the problem before I treat it…

Ladies (or gentleman who know some ladies), have you or anyone you known been diagnosed with PCOS and not had all the symptoms? So far my only indicator is the hair problem and the cyst on my left ovary. I’m going to make an appointment with another doctor to get to the bottom of this, but perhaps in the meantime you can share some stories, advice, knowledge etc? Thanks!

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12 Answers

downtide's avatar

It doesn’t have to be PCOS; the one cyst could cause it, as an ovarian cyst will raise your natural testosterone levels and that is what causes things like increased body hair. As for other symptoms, you wouldn’t necessarily get them all. Testosterone affects different people in different ways and it’s not always possible to predict which effects will show the most, or first.

creative1's avatar

Polycystic ovaries look actually look different on ultrasound pictures (scroll down to where it says polycystic ovaries) The eggs actually form a pearl necklace along the outside of the ovary where as a normal ovary the eggs form through out the ovary. One cyst could just mean you are in the place in your cycle where its still building and hasn’t released the egg. With polycystic ovary syndrome you also have insulin resistance and higher than normal testosterone. You would want to find a Reproductive Endocrinologist to get diagnosed properly. What I have found that worked and got my PCOS in check was taking Metformin which is a diabetic medication. With PCOS you go months without your period, I went many times over 9 months without a period before getting everything working again.

The hair on your face could be a result of PCOS because of the higher than normal testosterone (mine is 4 times the amount that a woman has). I tried having laser done to get rid of it but they don’t have much luck with doing above the neck but if your having that much of an issue on your stomach I would suggest doing it there so it is permanent hair removal. The reason the testosterone is so high is because your ovaries produce it and if you have more than one cycst forming it is producing more testosterone.

Undiagnosed for not getting your period regularly you are at a higher risk of getting uterine cancer because of the build up of lining. I was lucky when they finally diagnosed mine that it didn’t happen.

ImNotHere's avatar

Thanks for the responses. I didn’t know that one ovarian cyst can raise testosterone so that’s kind of interesting. To be honest, the doctor who found my ovarian cyst was a resident radiologist and very new so it wouldn’t surprise me if he did miss some. He said it was rather large but didn’t seem alarmed by it. Perhaps there are more? Also another weird thing is that my periods have largely been normal my entire life. The only time I’ve ever had so much as a ‘hiccup’ in my cycle was after I got my IUD, but it seems to be re-stabilizing…

downtide's avatar

@BringsTheNight I didn’t know either until I began transition (female to male). It turned out that my baseline testosterone was already higher than normal and after ruling out PCOS the doctor suggested an ovarian cyst might be responsible. However an ultrasound scan turned up negative for that too.

marinelife's avatar

You need to see a good doctor who specializes in Ovarian cysts. No one, not even you, can guess your diagnosis.

You may be annoyed at the doctoring you have had so far, but don’t give up.

Find and expert in the field. You should be able to find someone good in New York.

CWOTUS's avatar

Good luck with your medical issues and working with your doctor. I don’t have any better advice than anyone else about that.

However, the idea that shaving “makes the new hair come in stronger” is a myth. Don’t worry about that, anyway.

linguaphile's avatar

Like @marinelife says, find a specialist. You can find one at the American Association of Clinical Endocrinologists I found the best PCOS doctor I’ve had in the past 15 years from this web site.

I have PCOS that’s well managed, but what you’re describing with your hair seems to be excessive, even for PCOS, so yes, go see an endocrinologist.

Neizvestnaya's avatar

Unless a doctor sends you for a internal/vaginal wand scan (like an ultrasound) then there is always a risk of ovarian cysts and tumors. These tumors can grow inside and also outside the uterus and yes, they mess with your hormone balances. Err on the side of caution, get checked regularly.

MagsRags's avatar

@downtide I’m a women’s health care nurse practitioner and would have to disagree with the doctor who told you a single ovarian cyst can significantly raise testosterone levels. The reason testosterone goes up with PCOS is because each of those little partially ripened ovarian follicles are contributing a little testosterone and it adds up. One big cyst doesn’t secrete the testosterone of 20 little ones. Then there’s the interplay between ovaries, adrenal glands, body fat, skin, etc.

I’m at home today so don’t have access to my usual reference resources – they’re at the office. But with a quick online search, here is a pretty good and in depth online article about androgen excess, and how it’s not just about ovaries and not just about testosterone.

@BringsTheNight you mentioned that you have an IUD – is it a Mirena? Mirena users are a little more likely than other women to develop an ovarian cyst it happens to about 12%. Not multiple little cysts, but a larger one that might be painful. They usually go away on their own within a month or two.

Have you ever had a problem with irregular/far apart periods? As @creative1 mentioned, thats another symptom of possible PCOS. Are other women in your family fairly hairy? There’s definitely a genetic component to this. Women of Mediterranean descent Italian, Spanish, Greek, Middle Eastern etc tend to have more body hair.

If I was seeing you in the office and we were doing bloodwork to look at possible hormonal causes, I’d be checking free and total testosterone, SHBG and DHEA to start.

In terms of treatment options for the hair, there is a by-prescription lotion called Vaniqa that works well, albeit not permanently. It actually works on one of the enzymes in the hair follicle. It takes 4–8 weeks to see improvement and if you stop, you go back to where you started after 2 months without it. It’s spendy, but may be worth it to you.

ImNotHere's avatar

@CWOTUS I’ve also heard that shaving making hair stiffer isn’t necessarily true. Apparently it makes the end of the hair blunt so it just seem thicker. However, for me, it definitely did something because the hair hasn’t been the same since. I thought tweezing it from the root would be best to help it grow in finer but apparently that might even be making it worse! I’m really thinking laser and/or electrolysis are going to end up being my best options though I hate to spend the money at the age of 22… >.<

@MagsRags Thanks for the informative answer. The doctor who found the cyst didn’t really tell me anything about it except that it was nothing to worry about. I had to research on my own to find out it was anything to be concerned about… My IUD is a Paragard because I had a negative experience with hormonal birth control and wanted something reliable and long-term. My mother is half Italian, half German and my father is 100% German. My Mom isn’t any hairier than you would expect her to be…as far as I know. My periods have always been regular and pretty normal but are now much heaver/more painful with the Paragard (as I expected) I’ve looked into Vaniqa but I was thinking that money would be better spent on more long-lasting treatments.

linguaphile's avatar

Before you spend your money on laser treatments, make sure you have the skin for it. It works very well on fair skin with dark hair and almost doesn’t work on light hair. For light hair, electrolysis is better. If you tan, you’ll have to stop for the laser to work at its best. Also, if you’re prone to hyperpigmentation, make sure the technician knows this—you might have to shop around for the right type of laser center that will use a machine that doesn’t create hyperpigmentation. (there are different types of laser machines)

My friend ( a guy ) decided he wanted all of his arm, chest and leg hair removed, but he came from Puerto Rican and Cuban parents. To make the laser treatments work, he had to stay out of the sun 100% (while living in Florida) and did it, but said that after a while, his body developed a vitamin D deficiency that he had to correct with pills and milk until his laser treatment regiment was over. Now he’s completely hairless, tan as heck and still needs vitamin D supplements.

I would go to a reputable laser places even though they might cost a little more, not the corner beauty shop because they usually give more ‘bang for your buck’ and will know how to prevent unwanted side effects.

MagsRags's avatar

The other medication option might be a diuretic called spironolactone. It has a mild anti-androgenic effect. There are potential side effects, of course, but most women do fine as long they start on a low dose and then gradually increase. It takes a few months to notice a change, but the hairs usually get sparser and downier.

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