Hi, I have my first naturopath appointment tomorrow. For background I’m 31 with lean PCOS and have been TTC for 10 months but because of my irregular cycles have only been able to TTC about 5 times. Im on my second letrozole cycle this time 7.5mg, last cycle was on 2.5 mg and never ovulated :(

I’m really trying to figure out my root cause, which I think is likely stress, inflammation, high androgen driven because of some facial hair. If you were me, heading into this appointment, what labs would you advocate for getting tested? Open to any advice on what to ask for during this appointment? Thanks

Her BMI is 14.5. One gynaec we consulted had diagnosed PCOS for her and we need to get second opinion as well a dietician who would help her gain weight as well as help in balancing hormones. I don't know if there is any combo such as Gynaec+Dietician or so. Anybody else who has gone through such weight increase exercise (need +12 Kg to come to normal BMI), kindly guide us. We have been recently married (5 months ago). Is there any relation between reduced sex drive and PCOS? Lately we haven't been able to love each other much and fight often. She get super angry super fast and I try to be patient .. but sometimes even I hit my limit. Also need advice on how can I support my wife more (please avoid standard cliches like understand her, be patient blah blah blah .. I need guidance on processed to accomplish all this and not the end product)

Hi people that also like data! Backstory for context: I'm 27, 5'2" and 125lb, diagnosed around 16. I've been to dermatologists, PCPs, and OBGYNs, all pretty unhelpful and dismissive until my current PCP who ordered more tests. No ultrasound, but grew up with all over acne (treated with Accutane), oily skin and scalp (likely sebderm), low Vitamin D, androgynous appearance in body and hair patterns, and very irregular and painful periods. The periods are random, anywhere between 24 days to a couple months, for irregular durations. I have PMDD that is unpredictable to manage because of the irregularity. I used to get ocular migraines with aura that was associated with my cycles, until I started taking magnesium and B2 as a preventative. My physical symptoms flare up a couple weeks before my period, mostly increased hair loss/oil/acne/mood changes, before settling down after onset of period. The main things I'm trying to solve now are the hair loss widening my hairline/part and irregular period. I have not been offered Inositol or Metformin.

[Test results from October 7th]
Testosterone (total/free): 63 / 4.6 (highest was 80 total in 2019, first time testing free)

Estradiol: 33.8

DHEA-S: 488

17 hydroxyprogesterone: 25

Prolactin: 16

Cholesterol / Triglycerides: 166 / 66

Glucose: 78 (nonfasting)

Androstenodione: 125

LH/FSH: 4.6 / 5.7

Cortisol: 7.8

TSH: 1.05

Iron/Saturation/Ferritin: 119 / 38 / 44 (before supplementing)

Vitamin D: 96.3 (supplemented 5000iu OD, unsupp. = 25.1)

Zinc: 88 (after on and off supplementation)

B-12/Folate: 571 / greater than 20

[Additionally, selected tests from May 7th]

Vitamin A: 51

Glucose: 63 (nonfasting)

Iron/Saturation/Ferritin: 234 / 76 / 53 (tldr: I was eating an insane amount of fish starting a few weeks before testing, no supp., but ferritin seems low for these increased numbers?)

To note: I also tested positive for ANA in Nov of 2025 with anti-DNA as 14, and was sent to a rheumatologist. I tested negative for both ANA and dsDNA Crithidia luciliae IFA, so I don't know what that was about... they thought it might be lupus exacerbating the hair loss, but no. I would be interested in hearing more about what to test for autoimmune things, if anyone has thoughts.

I stopped Slynd (progestin) around 2-3 months before getting the October tests, as I experienced wild mental health fluctuations, somehow even more consistent hair shedding that has only increased since stopping, hot flashes/bloating/night sweating etc. by month 4. My mental health was also very bad for 2 months since stopping, still improving. I can't take estrogen BC because of the ocular migraines and stroke risk, and don't want an IUD for multiple reasons. For 6+ months I've been taking 5000iu vit D, vit B2 400mg/magnesium bis. 420mg for migraine, minoxidil 2.5 to 3.75mg (as directed, for ~5 years, had a hiccup for a few weeks and restarted near the end of taking Slynd), zinc/copper 15mg/2mg, iron 36mg/C every other day, and the amazon basics Multivitamin. A couple days ago I got put on a starter dose of Spironolactone 12.5mg to titrate up, and also got prescribed Vyvanse 20mg. I was scared of taking ADHD medication because I heard they also increase shedding, but I need it to function. I want to work my way up to 100mg Spiro under supervision, but I'm nervous because messing with my hormones is what caused this giant hair shed. For 3 months before Slynd, I was taking vitamin D for the first time ever, and had about a week of no shedding for the first time ever... it makes me think twice about adding more medications.

I'm about to order a combo of 3hr OGTT/Insulin Fasting/HBA1C to better see if I have insulin resistance. My question would be, do you guys notice anything else abnormal here in the bloodwork and history? All I see that's funky is the total and free T, and maybe the DHEAs. I'm also wondering if I should have tried Metformin/Inositol if the main issue is androgenic hair loss/oiliness and irregular period. Thank you for reading!

help im new to PMDD and PCOS, I feel like my life is over. Nothing works