Hello I have PCOS, 3 doctors confirmed it About a

Patient

Q: Hello. I have PCOS, 3 doctors confirmed it. About a year ago I had irregular menstruation for about 2 months because of 2 2cm cysts. Usually my periods are regular and relatively painless. I am 19 years old and not at all overweight. I became sexually active in November 2014. Sex was very painful, because I sometimes felt some sort of weird uterine cramping during. Once post sex I even felt a strange pain in my butt, and it lasted a few days. Anyway, late January of 2015, about a week after I finished my period, I was extremely naseous and irritable. I also felt weird sharp pinches in my lower abdomen (in what I'm assuming are my ovaries) bilaterally, that sometimes came about with movement, such as getting out if bed quickly. Then the spotting started. I was lightly spotting for 4 days, and then it got heavy. The spotting was (is) sometimes brown, sometimes pink or red or even purple. Anyway, that first time I spotted for 2 weeks, stopped for 3 days, and started again. Then I went to a doctor and she gave me medroxyprogesterone. A normal period started, and then I started taking birth control (minastrin 24 fe). The doctor said my hormones are normal, and my ultrasound was normal except for the PCOS. I recently went to another doctor and she said the same exact thing. However, the spotting is not going away. It's been 4 months. It always occurs around 1.5 weeks after my period ends. It lasts around a week now. There is always bilateral lower abdomen pain before the spotting and during. The spotting is light, but it is bright red or pink for almost the entire time. The pain is getting sharper and more pronounced. Please help me, this is causing me great stess, and I can't seem to find an answer from anyone

Symptoms:  Spotting
Lower abdomen pain
Doctor

A:   Hello,
Thanks for the query.
PCOS is a condition that causes irregular cycles and many other symptoms along with it.The syndrome can persist for a long time, sometimes even until meopause.
There is a hormonal imbalance on and off in your body that causes irregularities in menses. However, the symptoms are well controlled with medications. Hormonal pills and metformin are generally recommended for many months until the cycles get regular. In PCOS,the ovaries produce muliple cysts ans enlarge in size. You seem to have the spotting everytime during the ovulation period. This is experienced in normal woman also during ovulation. There will be cramps and spotting at the time of ovulation and generally stops by itself in a day. However, in PCOS, the ovaries are enlarged and mulitple cysts are present that makes the ovulatory bleeding to be more and painful as well.
The trearment for this specific symptom would be taking an analgesic like paracetomal or antispasmodic like dicyclomine to reduce cramps. Hot fomentation will help. Drink plenty of water and fruit juices. Have a healthy diet and avoid smoking. Continue the routine medications as well. Avoid coffee, tea and caffeine containing beverages. Lifestyle modifications like regular exercises and meditation will help you. Do not stop any medication that is given to treat the irregular cycles. In case symptoms persist, you can opt for a surgical option called ovarian drilling to drill the cysts and r reduce the symptoms.
You can write back for further clarifications.
Hope this helped.
Regards

Comments / Follow Ups

Patient: Thank you doctor that was helpful
You mentioned that there is a hormonal balance going on and off in my body. That makes sense of course, but the thing is all my blood tests come out negative for any hormonal abnormalities. Could that be indicative of a condition other than something (directly) PCOS related? I've been googling stuff like crazy for the past 4 months, and now I'm paranoid that I have a bunch of other conditions (ovarian cancer or endometriosis or I don't even know).
Currently I am having spotting, and I've been having it for an entire week. It's very light but it's always bright red.
There is less and less cramping (during this time I rarely had cramping, just sharp bilateral pinches) but still
Thank you
Doctor: Hello,
Thanks for the reply.
You need not worry about having the conditions like ovarian cancer or endometriosis. They can always be detected by tests and ultrasound. Since all your tests have been negative, there doctor would have surely excluded the conditions.
A hormonal imbalance can happen anytime. Sometimes even in between the interval of the tests. This may go un noticed.
Do not worry about the spotting and continue the same medications. Get a pap smear done if it was not done before to make sure the cervix and uterus are normal in function.
Hope this was reassuring.
Regards

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