Gillian Goddard

3 min Read Gillian Goddard

Gillian Goddard

Does Elevated Testosterone Mean I Have PCOS?

Q&A on diagnosis

Gillian Goddard

3 min Read

When I was young, I had elevated levels of testosterone, and I do have a lot of hair on my upper lip and chin/neck. However, I have never had cysts on my ovaries and got pregnant very easily. Because I have the first two symptoms, does it automatically mean I have PCOS?

—Hormonally Hairy

Many women come to me because they are trying to understand if they have polycystic ovary syndrome, or PCOS. Often they have some symptoms — either body hair growth, scalp hair loss, acne, or irregular periods. Often they have been told by one doctor that they have PCOS and by another that they don’t. By the time they reach my office, they are confused.

The root of all this confusion is twofold: the name of the syndrome is misleading (see below), and a diagnosis of PCOS is made on a clinical basis, meaning there is no one lab test or radiology test that says a woman does or does not have PCOS. Basically, doctors like me are supposed to rule out some other diseases that can cause similar symptoms and consider your overall presentation and come to a conclusion. It isn’t surprising that we disagree sometimes.

Add to that, different medical groups define PCOS slightly differently. The National Institutes of Health defines PCOS as irregular or absent ovulation and signs of high male hormone levels. Many doctors use what’s known as the Rotterdam criteria, which have been updated over the years. Most recently those criteria define PCOS as having two of the following: evidence of high male hormone levels in the blood or in the form of excess body hair growth, scalp hair loss, or acne; infrequent or absent ovulation, which many women will experience as irregular or absent periods; characteristic cysts on the ovaries. 

If you have irregular periods and signs of high male hormones, you do not need to have cysts to meet those criteria. In fact, not all women with cysts have PCOS and not all women with PCOS have cysts.

I would argue on some level that whether or not you have PCOS should not impact your treatment. Hear me out. PCOS is a syndrome — just a constellation of symptoms that are often seen together — not a disease. We do not really understand what causes it, and we cannot cure it. We manage PCOS by treating the symptoms that bother you, and we would treat them the same way whether your symptoms are caused by PCOS or not.  

Regardless of whether you have PCOS, if your symptoms are bothering you, you should discuss treatment options with your doctor.

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The list of what not to do while pregnant feels longer than a CVS receipt. At ParentData, we want to empower you to make the right decisions for you.

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#emilyoster #parentdata #pregnancyproblems #pregnancymyths
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☀️ If you want to add a little sunscreen on their hands and feet? Go for it! But be mindful as baby skin tends to more prone to irritation.

Comment “Link” for a DM to an article on the data around sun and heat exposure for babies.

#sunsafety #babysunscreen #babyhealth #parentdata #emilyoster
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OUT NOW: My new book “The Unexpected: Navigating Pregnancy During and After Complications” is available on April 30th. All of my other books came out of my own experiences. I wrote them to answer questions I had, as a pregnant woman and then as a new parent. “The Unexpected” is a book not to answer my own questions but to answer yours. Specifically, to answer the thousands of questions I’ve gotten over the past decade from people whose pregnancies were more complicated than they had expected. This is for you. 💛 Order now at my link in bio!

OUT NOW: My new book “The Unexpected: Navigating Pregnancy During and After Complications” is available on April 30th. All of my other books came out of my own experiences. I wrote them to answer questions I had, as a pregnant woman and then as a new parent. “The Unexpected” is a book not to answer my own questions but to answer yours. Specifically, to answer the thousands of questions I’ve gotten over the past decade from people whose pregnancies were more complicated than they had expected. This is for you. 💛 Order now at my link in bio! ...

OUT NOW: My new book “The Unexpected: Navigating Pregnancy During and After Complications” is available on April 30th. All of my other books came out of my own experiences. I wrote them to answer questions I had, as a pregnant woman and then as a new parent. “The Unexpected” is a book not to answer my own questions but to answer yours. Specifically, to answer the thousands of questions I’ve gotten over the past decade from people whose pregnancies were more complicated than they had expected. This is for you. 💛 Order now at my link in bio!

OUT NOW: My new book “The Unexpected: Navigating Pregnancy During and After Complications” is available on April 30th. All of my other books came out of my own experiences. I wrote them to answer questions I had, as a pregnant woman and then as a new parent. “The Unexpected” is a book not to answer my own questions but to answer yours. Specifically, to answer the thousands of questions I’ve gotten over the past decade from people whose pregnancies were more complicated than they had expected. This is for you. 💛 Order now at my link in bio! ...

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📈 Robert M. Silver et al., “Prospective Evaluation of Maternal Sleep Position Through 30 Weeks of Gestation and Adverse Pregnancy Outcomes,” Obstetrics and Gynecology 134, no. 4 (2019): 667–76. 

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Is side sleeping important during pregnancy? Comment “Link” for a DM to an article on whether sleep position affects pregnancy outcomes.

Being pregnant makes you tired, and as time goes by, it gets increasingly hard to get comfortable. You were probably instructed to sleep on your side and not your back, but it turns out that advice is not based on very good data.

We now have much better data on this, and the bulk of the evidence seems to reject the link between sleep position and stillbirth or other negative outcomes. So go ahead and get some sleep however you are most comfortable. 💤

Sources:
📖 #ExpectingBetter pp. 160-163
📈 Robert M. Silver et al., “Prospective Evaluation of Maternal Sleep Position Through 30 Weeks of Gestation and Adverse Pregnancy Outcomes,” Obstetrics and Gynecology 134, no. 4 (2019): 667–76.

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I co-wrote #TheUnexpected with my friend and maternal fetal medicine specialist, Dr. Nathan Fox. The unfortunate reality is that about half of pregnancies include complications such as preeclampsia, miscarriage, preterm birth, and postpartum depression. Because these are things not talked about enough, it can not only be an isolating experience, but it can also make treatment harder to access.

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#pregnancy #pregnancycomplications #pregnancyjourney #preeclampsiaawareness #postpartumjourney #emilyoster
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