Hair loss, pcos? cah?

Patient

Q: I am only 24 years old and i have problems losing weight, ive always had an irregular cycle, the past 6 years ive had hirsutism and the past 2 yrs ive had a great deal of hair loss on my scalp to the point that i have a very noticable bald spot. This is my main problem and why i am writing. I went to my endocrinologist and he tested my blood sugar, thyroid and cortisol through a 24 hr urine collect..these were all fine. He also tested my testosterone levels and said that they were very high and this was either because i have polycistic ovarian syndrome or congenital adrenal hyperplasia. He put me on a low dose of dexamethasone and spirinolactone. My question is that if the root cause of pcos is insulin resistance and my blood sugar levels are fine then wouldnt that rule out PCOS? and since my cortisol levels are fine then shouldnt that rule out CAH? im just not sure why my doc thinks that my testosterone levels are high becuz of pcos or cah if my insulin and cortisol is fine..also i am having scalp pain in the spots where im losing the most hair which my doctor didnt have an explanation for..i feel like crying..please help..i want to grow back the hair that ive lost but dont want to take any lifelong drugs in order to do that

Doctor

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