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FAQs concerning the diagnosis of PCOS

How should Polycystic Ovary Syndrome (PCOS) be diagnosed?

PCOS should be diagnosed by a credible physician who will begin with a basic physical examination. He/she may also want to have an ultrasound done of your ovaries and require a number of blood tests. Be sure to let your physician know if you are experiencing any of the symptoms of PCOS. There are a number of doctors who feel that a woman must have at least three of the symptoms prior to diagnosing PCOS. Other doctors may make the diagnosis based on the emphasis on lack of ovulation.

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How are polycystic ovaries diagnosed by ultrasound?

Ovary ultrasound showing cystic ovaries courtesy of LearningRadiology.com

Ovary ultrasound showing cystic ovaries courtesy of LearningRadiology.com

An ultrasound of the ovaries is usually done by placing a probe into the vagina to view the ovaries. Sometimes, an abdominal ultrasound is done but a transvaginal ultrasound is preferred.

A classic PCOS ovary is enlarged and has a “string of pearls” appearance, where the “pearls” are the cysts. Usually ultrasound diagnosis of polycystic ovaries is made if there are at least 8-10 cysts that are less than 10mm in size on each ovary. The polycystic ovary tends to be enlarged to 1.5-3 times the size of a normal ovary.

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Is it possible to have polycystic ovaries without having the syndrome?

Yes. It is estimated that out of 20 to 30% of women, only 5 to 10% will be diagnosed as having Polycystic Ovary Syndrome based on their symptoms. Having cysts on your ovaries is not a definitive criteria to having PCOS. However, a large number of women with ovarian cysts also display other symptoms hormonally of having a predisposition for PCOS.

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Is it possible to have PCOS without having cysts?

The medical jury is still out on this subject. Some physicians believe that if a woman is exhibiting a number of PCOS symptoms but do not have cysts, that does not necessary mean that they do not have the syndrome. However, it is difficult to make a firm diagnosis of PCOS without the presence of either an increased number of small cysts or ovarian enlargement. Furthermore, in most cases, if a patient is displaying other symptoms, the likelihood of some ovary irregularities.

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Woman with Alopecia Areata since childhood

Story from a 41-year-old woman with alopecia areata who has difficulty getting comfortable with her hair loss:

Bald patches began at age seven. Cortisone shots directly into the patches worked temporarily. When patches came back around age nine I was treated with: more shots in scalp, Topsyn ointment and also fluorescent light treatments. Eventually all of my hair fell out. By age 15 I was asked to participate in the Minoxidil study. I used it at (what is now considered to be) 100x current market strength. It did not work for me. By age 17 my eyebrows fell out. By age 23 my eyelashes, once lush and long, also fell out. Half of my mons is also bald–the rest is pale blonde and thin. I have transparent hair growth under my armpits and shave it off once every ten days or so. I haven’t shaved my legs since I was thirteen. I am now 41 years old, married, and have two children who do not have this disease. I wear a wig, and every day is hell for me because it is not comfortable. I just want my hair to grow back, once and for all, so I can feel normal again. I have never settled and gotten used to this, but I’ve made the best of it from what I have.

Thank you for sharing your story!

What Causes Androgenetic Areata?

Hair follicles contain androgen receptors. In the presence of androgens, genes that shorten the anagen phase are activated, and hair follicles shrink or become miniaturized. With successive anagen cycles, the follicles become smaller (leading to shorter, finer hair), and nonpigmented vellus hairs replace pigmented terminal hairs. In women, the thinning is diffuse, but more marked in the frontal and parietal regions. Even persons with severe androgenetic alopecia almost always have a thin fringe of hair frontally. The remaining hair configuration may resemble a monk’s haircut.

Women with androgenetic alopecia do not have higher levels of circulating androgens. However, they have been found to have higher levels of 5a-reductase (which converts testosterone to dihydrotestosterone), more androgen receptors, and lower levels of cytochrome P450 (which converts testosterone to estrogen).

Most women with androgenetic alopecia have normal menses, normal fertility, and normal endocrine function, including gender-appropriate levels of circulating androgens. Therefore, an extensive hormonal work-up is unnecessary. If a woman has irregular menses, abrupt hair loss, hirsutism, or acne recurrence, an endocrine evaluation is appropriate. In this situation, total testosterone, free testosterone, dehydroepiandrosterone sulfate, and prolactin levels should be obtained.

Because the hair loss in androgenetic alopecia is an aberration of the normal hair cycle, it is theoretically reversible. Advanced androgenetic alopecia, however, may not respond to treatment, because the inflammation that surrounds the bulge area of the follicle may irreparably damage the follicular stem cell.

I’m 32 and I’ve had 4 battles with Alopecia Areata.

Story from a woman who has battled alopecia areata resulting from severe trauma and/or stress:

I’m 32 and I’ve had 4 battles with Alopecia Areata. Every time something major happens I begin to start loosing a patch of hair. First, when I made a huge move across country and left all my family, a spot started. (pretty scary) since it was the first time. The second time, I was in some financial problems, and again it started. The second times, I had deaths in the family a few years apart, and again, the patches came up. It’s a horrible feeling to have a full head of hair, and then all the sudden a small little patch starts and you start praying that it stops or doesn’t get that big. Currently, I have two huge spots on the back of my head that barely have any fuzz at all. In fact, some of the grey hairs stayed, and the brown didn’t. Weird. I’m not on any medications since the other times it grew back fairly quickly (6-9 months), but I think I’m going to find something this time since their much bigger than before.

Thank you for sharing your story!

AGA – Photo image of onset

Image photo of the onset of Androgenetic Alopecia in a female courtesy of www.aafp.org

Image photo of the onset of Androgenetic Alopecia in a female courtesy of www.aafp.org

Bald Girls Do Lunch: News Clip

Bald Girls Do Lunch on KSTU TV in Salt Lake City, Utah.

One Life: Gail Porter Laid Bare {video clip}

In this powerful clip from the BBC documentary “One Life: Gail Porter Laid Bare,” Gail prepares to meet Michelle Chapman.

Video of Cosmetic Application on female alopecian

A female alopecian named Chrissy has her eyelashes and eyebrows done by a professional makeup artist.

Claire Taylor ~ NHS Choices Video

In this NHS Choices video, Claire Taylor, describes how she has coped with alopecia since age 11 and hasn’t let it stop her doing the things she loves. You rock, Claire!

What Can I Expect Next?

The course of alopecia universalis is highly unpredictable, and the uncertainty of what will happen next is probably the most difficult and frustrating aspect of the disease. You may continue to lose hair, or your hair loss may stop. The hair you have lost may or may not grow back, and you may or may not continue to develop new bare patches.

Is My Hair Loss a Symptom of a Serious Disease?

Alopecia universalis is not a life-threatening disease. It does not cause any physical pain, and people with the condition are generally healthy otherwise. But for most people, a disease that unpredictably affects their appearance the way alopecia universalis does is a serious matter.

The effects of alopecia universalis are primarily socially and emotionally disturbing. In alopecia universalis, however, loss of eyelashes and eyebrows and hair in the nose and ears can make the person more vulnerable to dust, germs, and foreign particles entering the eyes, nose, and ears.

Alopecia universalis often occurs in people whose family members have other autoimmune diseases, such as diabetes, rheumatoid arthritis, thyroid disease, systemic lupus erythematosus, pernicious anemia, or Addison’s disease. People who have alopecia areata do not usually have other autoimmune diseases, but they do have a higher occurrence of thyroid disease, atopic eczema, nasal allergies, and asthma.

Welcome to HerHairLossHelp.com!

women's hair loss treatment and cosmetic solutions information

Welcome to HerHairLossHelp.com! As a woman, losing hair or having thinning hair can be a devastating and often confusing experience. A number of women suffer hair loss whether it be through androgenetic alopecia, alopecia areata, universalis, telogen effluvium, etc. With all the possible triggers for our hair loss physically and emotionally, sometimes it feels as if it is a constant battle within to stay sane. However, you are NOT alone!

Her HairLoss Help was made by women with alopecia for women with alopecia, and is one of the longest running women’s hair loss support community just for women.

Please be sure to join us on Facebook to get information, learn about treatments available, find support during your quest to find answers, and chat with women who suffer from hair loss from all over the world. Ask a question and most likely you will be overwhelmed by the honest and straightforward answers you will receive. These women are warm and welcoming and sometimes a little looney…

We are so glad you are here!

PCOS ~ What blood tests to have done

What blood tests should be done to diagnose Polycystic Ovarian Syndrome (PCOS)?


Many doctors will require the following blood tests be done to successfully diagnose Polycystic Ovary Syndrome in a patient:

  • Fasting comprehensive biochemical and lipid panel;
  • 2-hour GTT with insulin levels (also called IGTT);
  • LH:FSH ratio;
  • Total testosterone;
  • DHEAS;
  • SHBG;
  • Androstenedione;
  • Prolactin and
  • TSH

Polycystic Ovary Syndrome

How common is PCOS?

It is currently believed that approximately 5 to 10% of women have Polycystic Ovary Syndrome (PCOS). It is the most common hormonal disorder in women of reproductive years and the leading cause in women for infertility. Since many women can have PCOS without exhibiting any symptoms, the actual number of women affected could be as much as 10% more of the population.

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What are the symptoms of PCOS?

Photo of a polycystic ovary courtesy of http://www.ovarian-cysts-pcos.com

Photo of a polycystic ovary courtesy of http://www.ovarian-cysts-pcos.com

Some of the most common symptoms include:

  • Amenorrhea (no menstrual period), infrequent menses, and/or oligomenorrhea (irregular bleeding) Menstrual cycles can often be scant, irregular and infrequent or may also exhibit in the form of spotting throughout the month.
  • Oligo or anovulation (infrequent or absent ovulation) Women with PCOS generally produce an egg but they don’t fully mature. Instead, these immature egg sacs can create ovarian cysts.
  • Hyperandrogenism Women who have PCOS generally also have an increase in serum levels of male hormones such as testosterone, androstenedione, and dehydroepiandrosterone sulfate (DHEAS).
  • Infertility
  • Cystic ovaries Classic PCOS ovaries have a “string of pearls” or “pearl necklace” appearance with many cysts.
  • Enlarged ovaries Polycystic ovaries are usually 1.5 to 3 times larger than normal.
  • Chronic pelvic pain
  • Obesity or weight gain Most commonly referred to as an “apple figure”. PCOS women will generally gain weight primarily in the abdomen and waistline.
  • Insulin resistance, hyperinsulinemia, and diabetes Insulin resistance is a condition where the body’s use of insulin is inefficient.
  • Hirsutism (excess hair) Excess hair growth such as on the face, chest, abdomen, thumbs, or toes.
  • Alopecia (female-pattern baldness or thinning hair) The thinning most commonly occurs on the top of the head.
  • Acne/Oily Skin/Seborrhea
  • Acrochordons (skin tags)

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What causes PCOS?

The exact cause of PCOS is unknown. However, there are studies that may lead us to believe that there may be a genetic link. Just as one may have a genetic predisposition to diabetes, one might also have a disposition to PCOS.

Cipro Interacts with Thyroid Medication

Popular Antibiotic Interacts with Thyroid Medication

The British Medical Journal has reported on a several cases of unexplained hypothyroidism in thyroid patients (on levothyroxine) who were taking the popular antibiotic ciprofloxacin. Ciprofloxacin is the generic name for the fluoroquinolone antibiotic sold under the brand names Cipro, Ciproxin and Ciprobay, Cirpoxine, and Ciflox. The drug is primarily used to treat urinary tract infections, pneumonia, and sexually transmitted diseases. Ciprofloxacin was also in the news during the anthrax scare, given its use in treatment for anthrax exposure.
What the researchers found in these cases were evidence that oral ciprofloxacin interacts with levothyroxine (i.e., Synthroid, Levoxyl, Levothroid) if taken together. It’s thought that the ciprofloxacin may somehow decrease the absorption of the levothyroxine.

In one case, a woman taking 125 mcg a day of levothyroxine took ciprofloxacin (750 mg twice a day) and her TSH level rose to 44 after four weeks. Even when her dosage was raised to 200 mcg a day, her TSH didn’t respond. Only when the ciprofloxacin was stopped did the TSH return to normal. In another case, a woman who was stabilized on 150 mcg a day of levothyroxine saw her TSH go from 1.6 to 19 after 3 weeks of treatment with ciprofloxacin at 500 mg twice a day.

What Can You Do?

If you’re a thyroid patient who is taking ciprofloxacin, what should you do?

The research suggested that thyroid tests were normalized if patients took the levothyroxine and ciprofloxacin at least six hours apart.

So, if you are on levothyroxine, it makes sense to allow at least six hours apart from taking your ciprofloxacin. And if you have to take the antibiotic for a lengthy period, you should discuss the potential impact on your thyroid with your doctor, and possibly request period thyroid testing to ensure that your thyroid treatment is not affected.

Source: Cooper, John, “Ciprofloxacin interacts with thyroid replacement therapy,” British Medical Journal, 2005