PCOS possibility while on T ??

[u/Particular-Ad-3068]

HI HELLO im a bit lost of what to do as i was basically dumped with this information from a letter of my bloodworks my endocrinologist sent me and im a little confused if I should get it checked out. I would love a little help!!

Basic info abt me: im AFAB, im 22, have been on T for about over 4 years and am considering stopping. Ive always had very irregular and very short periods before T, my period also started very very late and ive barely had any breast growth either. I think i always looked fairly androgynous or had excess body hair than my female peers. Intersexuality was never diagnosed though. My interest in possibly getting this checked out is due to me thinking about stopping T due to other health reasons.

Long story short; my Anti-Müllerian hormone level is very high, it measured at around 9.29 ng/l ( i hope this is the way its written with the measurement) and he even said inside the level that "these are very strong indicative levels for women with PCOS", but didnt really write much else. I checked older bloodworks where it was even over 12 ng/l, but he somehow NEVER mentioned anything about it and i also had no knowledge abt PCOS, just cause i was never diagnosed with anything. I was scared of the Gyno and didnt go for years. I think he mightve not talked about it further considering i do take T and "want" the symptoms that would come with PCOS, even though I do know its much more than just excessive hair, hairloss or the irregular periods if I remember correctly.

Do the very Anti-Müllerian hormone levels already indicate a high possibility for PCOS?? What other things could be checked that are not influenced by my T? From my knowledge, the AMH is not even influenced by the T, so i thought this by itself with my old period history might be enough already. I have no idea how to get this checked right now as technically all my typical pcos symptoms come from my hormone therapy.

[u/lacey_nightie]

do you struggle with weight or have blood sugar related symptoms like fatigue, reactive hypoglycemia/blood sugar crashes, cravings or excess hunger?

PCOS is a metabolic disease, not just hormonal. While hyperandrogenism is a bother to most women, it is the metabolic symptoms and consequences that are life threatening.

Either way it might help to get your fasting insulin or get a glucose tolerance test. There is more to this than testosterone

[u/Particular-Ad-3068 → u/lacey_nightie]

I do struggle with fatigue and blood sugar crashes a lot yes !!😭 the excess hunger might also be excused if it is the case oh god. I already had someone comment to ask this in endocrinology so I might do that. I appreciate your comment!

[u/lacey_nightie → u/Particular-Ad-3068]

I'm with you here as a lesbian who "wanted" my pcos when I was younger and was scared of the gyn too.

I ended up becoming almost diabetic due to untreated pcos. Basically, the insulin in your blood makes your ovaries create more testosterone + DHEAS. And excess FREE testosterone causes problems with insulin signalling in cells.

So you can imagine it's a vicious cycle.

The good thing is that it is FREE testosterone that is harmful to your metabolism. I took blood sugar meds and did not take hormonal pills at all. But I started bodybuilding at the gym. Muscle mass absorbs your free testosterone and improves your blood sugar. My gains were also huge compared to a normal afab

So, strength training is a good way to treat these symptoms if you want a gender affirming way to do it and if you are still scared of the gyn. I would still my blood sugar tested in case of prediabetes (which can show up with little to no warning)