NEED TO KNOW: DHEAS and PCOS

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DHEAS and PCOS

5 posts on this thread and the last post was on March 9th, 2007 5:38 PM by B. Jacobs, M. D.

ltp23 - March 7th, 2007 10:41 AM

Dr.Jacobs,

I read that article you linked up on a previous thread about low DHEAS levels. I found it interesting that DHEAS levels in an older woman decline, and that the one woman cited in the study that elevated her DHEAS showed a very dramatic appearance in her ovaries, replicating a younger woman's ovaries with good follicle development.

However, I further researched DHEAS in women with PCOS and found it is often elevated...too many follicles.

I am a thin, PCOS patient at FCI and would like to know if the metformin I take lowers or controls the DHEAS (which from what I understand is more of a male hormone...am I correct?) I asked my doctor to check my DHEAS levels to see if they are high, (waiting for results) but is there anything she can do to lower them if they are, despite taking the metformin? Can they increase the dosage of metformin? (All my other hormone levels are normal...FSH, LH, thyroid, estrogen (E2), progesterone, etc. and i seem to get a period every month.. (every 33-35 days without meds)...so could my DHEAS be the hormone giving me problems with ovulation?

BTW, I love this forum, you are very helpful with your expertise.

B. Jacobs, M. D. - March 7th, 2007 5:48 PM

DHEA is a PREHORMONE. The sulfated form, DHEA-S, is made by the adrenal glands. I do not bother to test DHEA-S. If I am worried about an adrenal etiology for PCO, I test the level of 17 hydroxyprogesterone. It is a prehormone in the pathwat to make cortisone. If the enzyme which works on it is deficient, a very common gene defect, a woman will have polycystic ovaries. In that case, DHEA-S may not be elevated to an appreciable degree. For more information about PCO, I invite you to see our web page, <www.texasfertility.com>.
Good luck.

ltp23 - March 8th, 2007 10:57 AM

I just got my DHEAS number back and it is normal at 169 (she said within the 40-325 range.) So you think that my 17 hydroxyprogesterone should be tested now (even though I have a normal DHEAS number) or should I forget about testing the 17hydroxyprogesterone level?

Thanks for your help.

B. Jacobs, M. D. - March 8th, 2007 5:55 PM

I do not know that you have an adrenal cause for your PCO. Most patients with PCO have insulin resistance, or are predisposed to insulin resistance. It is certainly reasonable to check your 17 hydroxyprogesterone. If it is elevated, you need to be on a very low dose of steroids at bed time, especially early in pregnancy.
Good luck.

ltp23 - March 9th, 2007 12:54 PM

All my blood tests are normal, even my glucose fasting tests, I've taken several of them, always normal, about 80-85 each time after fasting. I just feel very frustrated as I would like to know "exactly" what the defect is in my hormone system. So, thanks, I will tell doctor to test this hormone my next blood test next week. Maybe this is it.

One more final question though...I had a m/c about 8-1/2 weeks after IVF on Feb. 8 and I am still waiting for my period to come. It has been 30 days since, and still no sign of the witch (HCG was at 11 two days ago), will I get my period after the HCG is 0???

Or does my hormones start reving up again when HCG hits 0 for a new cycle? Meaning, I have another 28 days waiting for a period?

B. Jacobs, M. D. - March 9th, 2007 5:38 PM

The half life of hCG is about 36 hours. It should be negative within a week of your last test. After hCG is negative, your ovaries should begin to function again. Blood glucose does not provide information about insulin resistance. You need to check insulin levels in response to a glucose challenge. Unfortunately, recently, labs have been cutting corners with insulin assays, and I cannot rely on them, anymore.

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