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I just got a blood test back that said my testosterone is

Customer Question
517 Ng/dL. This seems...
I just got a blood test back that said my testosterone is 517 Ng/dL. This seems, well, bad, considering I am a woman. I am worried about the possibility of a hormone-producing ovarian tumor. Thoughts?
JA: Are you keeping a personal medical record while dealing with this?
Customer: Yes. Testosterone 1.5 years ago was only 46, so fine back then.
JA: Anything else in your medical history you think the doctor should know?
Customer: I have PCOS....and a family history of ovarian dermoid cysts and hysterectomies.
Submitted: 1 month ago.Category: Endocrinology
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Answered in 22 minutes by:
11/10/2017
Endocrinologist: drphophalia, Doctor replied 1 month ago
drphophalia
drphophalia, Doctor
Category: Endocrinology
Satisfied Customers: 36,435
Experience: Do adrenal, thyroid and parathyroid surgery regularly.
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Endocrinologist: drphophalia, Doctor replied 1 month ago

What is your age?

Do you have any symptoms?

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Customer reply replied 1 month ago
I am 32. I have always had infrequent periods due to PCOS, but they are usually heavy when I do get them. In the last year they have changed to maybe just bleeding 1 day or even just once in a day, then nothing for months. So that's different. Also more migraines than usual, 2-3 in last 6 months compared to 2-3 in a lifetime.
Endocrinologist: drphophalia, Doctor replied 1 month ago

Thanks for the additional information. I am writing the answer for you and will get back to you in 4-5 minutes. If you get a phone call request, you may ignore it as that is an automated site trigger. Thank you.

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Endocrinologist: drphophalia, Doctor replied 1 month ago

High testosterone is likely due to PCOS. It is a common feature of it. The high testosterone is not likely due to hormone producing tumor. Please read this excellent reference article about high androgens / testosterone in PCOS;

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3846536/

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

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Customer reply replied 1 month ago
Ok, but this paper said that " When imaging does not
identify ovarian or adrenal mass and the results of serum DHEAS
are normal, then it is considered an indirect evidence of ovarian
tumor if serum testosterone levels exceed 200 ng/dl. These
ovarian tumors secrete significant levels of testosterone or its
precursor, and rostenedione." Isn't 517 rather far from what the level should be, even with PCOS?
http://medcraveonline.com/MOJWH/MOJWH-05-00145.pdf
Endocrinologist: drphophalia, Doctor replied 1 month ago

Yes this is higher than the average PCOS women are seen.

PCOS is a diagnosis of exclusion that associates hyperandrogenism and ovulatory dysfunction.

Androgen excess is the main feature of PCOS, which is produced by ovaries as well as by the adrenal gland.

If the MRI of pituitary and CT scan of adrenal is normal; the high testosterone by these organs can be ruled and can be concluded due to PCOS.

It is privilege assisting you.

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Customer reply replied 1 month ago
Thanks!
Endocrinologist: drphophalia, Doctor replied 1 month ago

You are very welcome.

Was this helpful to you?

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Endocrinologist: drphophalia, Doctor replied 1 month ago

Following would help in PCOS;

1) Weight reduction. Loss of abdominal fat seems to be crucial to restore ovulation. If it is morbid obesity, Bariatric surgery may be advised. Otherwise dietary counseling and exercise would help in short and long term.
2) FSH stimulation with clomiphene HMG or pulsatile LHRH.
3) Reduction of ovarian androgen secretion by using oral contraceptives or LH-releasing hormone (LHRH) analogs.
4) Urofollitropin (pure FSH) administration.
5) Reduction of ovarian androgen secretion by laparoscopic ovarian wedge resection. Laparoscopic ovarian surgery (laparoscopic ovarian drilling) is a useful alternative that does not trigger ovary stimulation.
6) Metformin improves ovulation, insulin sensitivity.

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Endocrinologist: drphophalia, Doctor replied 1 month ago

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