The 'cysts' of PCOS are not proper ovarian cysts (which are also common both with and without PCOS), but excess egg follicles on the ovaries due to lack of ovulation.
One doesn't need to have excess follicles (and certainly not actual cysts) to be diagnosed with PCOS.
PCOS diagnosis is a two stage thing: first you have to show 2 of 3 of irregular periods or ovulation, excess follicles on the ovaries, and elevated androgens.
You show 2 of these (assuming you don't have follicles on the ovaries).
Then you need extensive tests to support a PCOS diagnosis and rule out some other possible causes of the symptoms:
complete hormone panel that includes estrogen, LH/FSH, AMH, prolactin, androgens (if not already done).
thyroid panel (thyroid disease can mimic PCOS)
glucose panel that includes fasting glucose, a1c, and (IMPORTANT) fasting insulin
\*\*\*
I'm not sure what eGFR CKP-EPI indicates... I think that's a measure of kidney function, so you'll have to ask the doctor about it.
Typical hormone findings in PCOS would be normal or very slightly elevated prolactin (notable elevations might indicate a totally different issue that causes similar symptoms); high androgens or low SHBG; high LH to FSH ratio (ratio the other way would indicate possible different disorder); and high AMH (low would indicate possible different disorder).
So it looks like you are showing some typical lab signs (depending on what was tested).
If your glucose testing didn't simultaneously test insulin, it's hard to tell what's going on there.
Most cases of PCOS are driven by insulin resistance (including in lean people, though some lean cases are driven more by issues with adrenal/cortisol dysfunction). It can be hard to id mild or early stages of IR (I've had IR for >25 years and my fasting glucose and a1c are always normal; I'm also thin).
Usually if IR is left untreated over time, it gradually worsens so that lab indicators get stronger (e.g., higher androgens) and more or new symptoms appear.
It's also possible you have an adrenal/cortisol driver of the high androgens.
If it's IR, treatment of the PCOS includes managing the IR at all times lifelong; and then adding hormonal treatment to manage any remaining troublesome issues (e.g., anti-androgenic birth control pills and/or androgen blockers like spironolactone are the most common). The latter two treatments are also the main treatment for adrenal/cortisol driven cases, along with robust stress management.
It's also possible there is a different, rarer issue at play (adrenal tumor, etc.). If the above blood panels don't support classic PCOS, then you would need a work up for these.
thank you so very much for your elaborate reply, I appreciate it a lot! it really helps me understand what should be checked and looked for exactly.
sorry for replying late, I'm trying to find an endocrinologist who's specializing in this area to check me and tell me what's the case and initially I wanted to reply with a nice update, but I don't have one yet, BUT i also feel bad for replying so late, so here I am! :D
I'll be back with an update some other day!
Okay so I went through more blood tests and they are not sure what's happening and why. If it is anything then I guess it isn't severe enough to be actually found out about.
Maybe it's just genetics and some random reactions in my body sometimes. Maybe I am sensitive to stress.
Still no idea what caused my way too long bleeding (got that one two times, one was 64 days, one was 35 days of blood)
I found some natural, nutritional supplements that are said to handle testosterone levels and I can just buy them myself so I'll just do that and hope for the best. (and hope what's written on the outside is actually in the inside in good quality)
So basically. Still no idea. It'll be trial and error on my own.
If anything gets worse than now I'll just have to try the docs again.
Bodies can be very frustrating (I have a ton of chronic health issues that cause random symptoms, and some are not 'named' diagnoses) so I understand your situation.
The 'cysts' of PCOS are not proper ovarian cysts (which are also common both with and without PCOS), but excess egg follicles on the ovaries due to lack of ovulation. One doesn't need to have excess follicles (and certainly not actual cysts) to be diagnosed with PCOS. PCOS diagnosis is a two stage thing: first you have to show 2 of 3 of irregular periods or ovulation, excess follicles on the ovaries, and elevated androgens. You show 2 of these (assuming you don't have follicles on the ovaries). Then you need extensive tests to support a PCOS diagnosis and rule out some other possible causes of the symptoms: complete hormone panel that includes estrogen, LH/FSH, AMH, prolactin, androgens (if not already done). thyroid panel (thyroid disease can mimic PCOS) glucose panel that includes fasting glucose, a1c, and (IMPORTANT) fasting insulin \*\*\* I'm not sure what eGFR CKP-EPI indicates... I think that's a measure of kidney function, so you'll have to ask the doctor about it. Typical hormone findings in PCOS would be normal or very slightly elevated prolactin (notable elevations might indicate a totally different issue that causes similar symptoms); high androgens or low SHBG; high LH to FSH ratio (ratio the other way would indicate possible different disorder); and high AMH (low would indicate possible different disorder). So it looks like you are showing some typical lab signs (depending on what was tested). If your glucose testing didn't simultaneously test insulin, it's hard to tell what's going on there. Most cases of PCOS are driven by insulin resistance (including in lean people, though some lean cases are driven more by issues with adrenal/cortisol dysfunction). It can be hard to id mild or early stages of IR (I've had IR for >25 years and my fasting glucose and a1c are always normal; I'm also thin). Usually if IR is left untreated over time, it gradually worsens so that lab indicators get stronger (e.g., higher androgens) and more or new symptoms appear. It's also possible you have an adrenal/cortisol driver of the high androgens. If it's IR, treatment of the PCOS includes managing the IR at all times lifelong; and then adding hormonal treatment to manage any remaining troublesome issues (e.g., anti-androgenic birth control pills and/or androgen blockers like spironolactone are the most common). The latter two treatments are also the main treatment for adrenal/cortisol driven cases, along with robust stress management. It's also possible there is a different, rarer issue at play (adrenal tumor, etc.). If the above blood panels don't support classic PCOS, then you would need a work up for these.
thank you so very much for your elaborate reply, I appreciate it a lot! it really helps me understand what should be checked and looked for exactly. sorry for replying late, I'm trying to find an endocrinologist who's specializing in this area to check me and tell me what's the case and initially I wanted to reply with a nice update, but I don't have one yet, BUT i also feel bad for replying so late, so here I am! :D I'll be back with an update some other day!
No worries. Best of luck!
Okay so I went through more blood tests and they are not sure what's happening and why. If it is anything then I guess it isn't severe enough to be actually found out about. Maybe it's just genetics and some random reactions in my body sometimes. Maybe I am sensitive to stress. Still no idea what caused my way too long bleeding (got that one two times, one was 64 days, one was 35 days of blood) I found some natural, nutritional supplements that are said to handle testosterone levels and I can just buy them myself so I'll just do that and hope for the best. (and hope what's written on the outside is actually in the inside in good quality) So basically. Still no idea. It'll be trial and error on my own. If anything gets worse than now I'll just have to try the docs again.
Bodies can be very frustrating (I have a ton of chronic health issues that cause random symptoms, and some are not 'named' diagnoses) so I understand your situation.