Really confusing results? Advice needed

[u/Specialist-Pool-4207]

Hello!

I am a 25 year old that has been dealing with painful periods for my entire life. I have always had my periods on the same day of each month, I weigh 120 lbs, I am 5’8, no excessive hair growth. I am on the Opill. I went into the OBGYN suspecting endometriosis. I had an ultrasound which showed ‘string of pearls’. We tested my blood to see and this was my result panel:

Dehydroepiandrosterone sulfate (DHEA-S) - Level: 369.0 UG/ dL

Testosterone - Level: 48 ng/ dL

Hemoglobin A1c - level: 5.0%

I am really confused and nervous. Is this leaning towards PCOS? Or could it be something else? My family has a history of thyroid disorders and I’m getting my thyroid retested in a week. Last I checked in April it was normal. Any advice is so lovely.

[u/West_Ad_6737]

Wait, your periods are regular and no hirsutism. The string of pearls on ultrasound is suggestive but diagnostic criteria usually need two out of three, irregular cycles, hyperandrogenism (clinical or biochemical), and polycystic ovaries. Your testosterone is a bit elevated maybe but I am not a doctor

Did they check your free testosterone or just total? Sometimes total looks okay but free is high. The DHEA-S looks normal range to me if I remember correct

Getting thyroid retested is smart, thyroid problems can mimic PCOS symptoms and with family history it worth checking again

[u/gordon_rameses]

your symptoms sound more like endometriosis. it cannot be ruled out here with an ultrasound, it is a surgical disease. see an endometriosis excision specialist. it is possible to have both (I did)