T Nation

Re: Case Study #1 in Think Tank Dialogs

Because we cannot post in there…I just want to offer suggestion

While I agree with Dr. Skeptix regarding it not being PCOS due to PMH, especially pregnancy…the rationale for infertility in PCOS, however, is usually attributed to the placement of a patient with such a condition on BCP’s to suppress LH. At which time, not mentioning if the patient took something like clomiphene is certainly missing. Granted, highly unlikely, but I do agree for different reasons unless her prescription drug Hx is complete, then I feel you offer decent rationale because it happens more often than not that patients would experience menstrual irregularities - including ammenorrhea (albeit this is NOT pathognomonic, however).

But how bout the absence of virilization or hirsuitism or other masculinizing traits which would be present in nearly all PCOS pts. due to increased LH --> increasing androgen synthesis. I think this is more likely the rationale of why it is easier to rule out…I have noted many a patient to become pregnant post-diagnosis.

TC, I would be curious to ask the patient about body hair patterns? Any changes (Increase or Decrease – especially axillary or pubic regions)? Not necessarily referencing to rule out PCOS.

Also, is the pt. able to lactate?