Is it REALLY PCOS or is it just post-pill PCOS?

[opatik9]

Hi!

I'm still trying really hard to navigate all of PCOS. I am hoping that some of my initial answers and personal background can be analyzed for my next steps.

It's hard for me to remember if I ever truly had regular periods when I was a teen because I was on birth control from 15 years to present (28 years old). The reason I went on BC was because I was having ovarian cysts rupture. I was never diagnosed with PCOS as a teen.

Since September 2021 (6 months) I've been off of birth control and I had two periods. One was in November and another in December. I haven't had a period since December so we are going on a few months.

My OBGYN ran blood tests for A1C (5.0), Fasting (97), TSH (2.11), HCG (<2.42), Full Blood Panel Lipids (all normal), DHEA (166.1), Testosterone (64), FSH (3.4), Estradiol (207), and Prolactin (17.67). So everything came back normal except the Estradiol and Testosterone. We also did an ultra-sound and found really no abnormal things except an enlarged right ovary and some POSSIBLE polyps on my endometrial lining (which she is going to do another follow-up ultrasound after going through a cyclic progesteron therapy round to see if those shrink because my lining is just very thick right now).

So with ALL of this said... is it safe to diagnose me with PCOS? I followed the chart and I don't know where to go with it because my doctor said that even though my insulin levels were FINE that I could still have a cellular base of insulin resistance even though all of that is showing up fine. And knowing that my "teen ovarian cysts ruptures" could have been just a teen hormonal thing doesn't really conclude to me have "unnormal periods". I also was never diagnosed with it as a teen. I have no idea if my periods were ever truly normal as a teen considering I had those ruptures... so I am either insulin resistant PCOS, post-pill PCOS, or inflammatory PCOS... but is it safe to say that I just have plain ole PCOS or am I being diagnosed without any other tests that she should be running? My OBGYN isn't familiar with the 4-types of PCOS... and I honestly haven't met many doctors that do follow that protocol. I will say that she is a DO and has approached my situation in a holistic sense and is a strong believer in BC not being the answer to all. She was also aware of the cyclic progesteron therapy-- which is cool too!

But, this is all to say that I don't really know how to supplement or what types of course to take considering I don't really know how to follow the chart or how to get my periods back on track. Is it just too soon after BC that this diagnosis should be made? I have been eating at around 2,300 calories and have not dieted for nearly 2 years, so it's safe to say it's not hypothalamic amenorrhea.

Any suggestions or thoughts would be VERY appreciated as what types of supplements I can start action with or how to approach this diagnosis.

I also will say that I am not looking to start a family yet... but in a few years I would like to start trying. I guess another question to start looking up is... "how can I track ovulation with PCOS?" Is there any information on that around here?

Thanks so much!