Diagnose me

[choopers1516]

Hi all, longtime lurker here.  Over the past year or so I've noticed some symptoms that I'm trying to figure out.  In the past few weeks I saw my PCP, had my pap done, and routine bloodwork, and everything came back normal except for very high cholesterol (178 LDL, 274 total).  I'm 39 and my BMI is 27, for what its worth.  Thyroid, A1C, and glucose levels came back normal, as well as tests for autoimmune conditions.

So my symptoms include: no period at all for the past 3 months despite PMS symptoms when I would expect my period (pregnancy definitively ruled out); extreme fatigue, especially when I wake up; post-exertional fatigue; dizziness; headaches; a significant increase in facial hair (which I pluck daily, super annoying).  I suspect PCOS.  I'll be seeing my gyno in a few weeks.  Any ideas what could be going on, or similar stories?  Thanks for your help!

[underwaterrhymes]

Perimenopause?

[cheekywife]

ditto perimenopause, definitely talk to your gyn and if you don't feel like they are listening or are being dismissive of your concerns, switch doctors. i like my PCP but i LOVE my gyn.

[cap]

I also think all of those symptoms could be caused by perimenopause.

[luckystar2]

I’d say perimenopause or thyroid rather than PCOS if you’ve never really had symptoms before.
If you haven’t had thyroid tested I would get that checked. That can cause period issues and high cholesterol.

[hermione]

A couple years ago I got horrific dizzy spells almost every time I stood up. They tested me for everything from ear infections to a brain tumor. Diagnosis: hormone shifts due to perimenopause. As others have noted, all of your symptoms can be attributed to that but it's good you are getting checked out.

[Aloe Vera]

I would go see an endocrinologist. Hormones out of wack cause your symptoms but you need to figure out what is causing your hormones to be out of wack. Could be perimenopause, but also thyroid, insuline resistance, non-alcoholic fatty liver...

[mcsangel2]

I think you should get all your hormone levels checked, as well as thyroid antibodies (I know you said you got your thyroid checked, but that almost never includes antibodies unless there's a known reason to check, and it is possible for your regular thyroid levels to be ok and have your antibodies be out of whack). Also, it's still possible to have an autoimmune condition (ore more than one) even if your ANA comes back negative.

[choopers1516]

Thanks all for your responses, it definitely sounds like perimenopause. I'll ask when I see my gyn in a few weeks!

[wanderingback]

Aug 6, 2025 15:17:01 GMT -5 mcsangel2 said:

I think you should get all your hormone levels checked, as well as thyroid antibodies (I know you said you got your thyroid checked, but that almost never includes antibodies unless there's a known reason to check, and it is possible for your regular thyroid levels to be ok and have your antibodies be out of whack). Also, it's still possible to have an autoimmune condition (ore more than one) even if your ANA comes back negative.

To clarify, we have 50+ hormones in our body! There is no reason to check ALL of your hormone levels. Need to go by what symptoms the person is having. 

OP, the more likely/common causes are perimenopause, PCOS, hypothyrodism or prolactinoma. 
I would definitely start with your gynecologist to rule out the more obvious things the cause secondary amenorrhea plus your symptoms and then if there is no insight after that discuss seeing an endocrinologist. Of course there could be one thing causing you to have secondary amenorrhea and something else causing your other symptoms, but starting with the most common things first is best practice 

Hope you get some answers and feel better soon. 

[circa1978]

You got really good advice. See an endocrinologist, even if a GP said your thyroid is fine, that can be very difficult to diagnose. My gynecologist actually was the first person to pick up on my Hashimoto's diagnosis, but I'd likely had it for some time, with GPs telling me I had anxiety.

And even if it IS "just" perimenopause, be prepared to have to aggressively advocate for yourself. My ovarian reserve is "fine" at 47, but trust me, I've been in peri for at least five years. I'm seeing a GYN who specializes in peri, later this fall, and am unreasonably excited.

[picksthemusic]

Had you had regular cycles up until 3 months ago? If so, I'd probably say it's not likely to be PCOS (I have PCOS, diagnosed by ultrasound and other symptoms since hitting puberty/starting my period).

Being that you had normal test results otherwise, it's likely perimenopause, but like wanderingback said, get checked out by the experts to rule out the truly bad stuff (or easily treated stuff).

This is timely, as I just saw my PCP to discuss perimenopause, and she put me on a low-dose monophasic estrogen/progesterone (birth control) pill to see if that helps my symptoms.

I wish you the best, and keep us posted as to what you find out!

[lovelovelove]

I would say have some reproductive hormones checked - my endocrinologist ran a panel for a potential PCOS diagnosis when I was having similar symptoms (he did say that the hormone panel might not confirm PCOS). My levels actually indicated ovarian failure so I'm on hormone replacement now and feeling much better.

[raleighnc]

I think most people show symptoms of PCOS earlier in life, but I used to have PCOS without insulin resistance and then about 7 years ago, I started having symptoms consistent with insulin resistance and eventually found a practitioner who diagnosed it. My lipid panels kept getting worse, along with extreme fatigue after eating, weight gain, swollen hands and feet, and abnormal muscle fatigue. I also had weird thyroid hormone levels - my free T4 kept drifting down to the bottom of the normal range, but my TSH was also low (instead of increasing when the free T4 decreased).

[choopers1516]

Thank you for all the information and support guys, this has been really helpful. I got my FSH and prolactin levels tested, and my PCP says they're normal. I'm very curious to hear my gyn's opinion.

I've actually been having shorter and lighter periods for the past year as well. My last period lasted for literally 10 hours, and the ones before that 1-2 days at most. This is a big change for me, since they used to last for 5-6 days and were very regular.

I have never tried hormonal BC, and I'm curious about whether it might help, so I'll ask at my appointment. The fatigue is the worst symptom -sometimes I have to sit down urgently because I feel like I might pass out. In the morning I have zero energy, it feels like I have the flu every day when I get up.

[wanderingback]

Aug 6, 2025 20:58:42 GMT -5 choopers1516 said:

Thank you for all the information and support guys, this has been really helpful. I got my FSH and prolactin levels tested, and my PCP says they're normal. I'm very curious to hear my gyn's opinion.

I've actually been having shorter and lighter periods for the past year as well. My last period lasted for literally 10 hours, and the ones before that 1-2 days at most. This is a big change for me, since they used to last for 5-6 days and were very regular.

I have never tried hormonal BC, and I'm curious about whether it might help, so I'll ask at my appointment. The fatigue is the worst symptom -sometimes I have to sit down urgently because I feel like I might pass out. In the morning I have zero energy, it feels like I have the flu every day when I get up.

For perimenopause there are no blood tests. We treat based on symptoms. Your symptoms sound definitely consistent with perimenopause with the change in menstrual cycle and now amenorrhea. Hormone therapy could definitely help. Hope you get some answers!

[choopers1516]

Aug 6, 2025 21:16:07 GMT -5 wanderingback said:

Aug 6, 2025 20:58:42 GMT -5 choopers1516 said:

Thank you for all the information and support guys, this has been really helpful. I got my FSH and prolactin levels tested, and my PCP says they're normal. I'm very curious to hear my gyn's opinion.

I've actually been having shorter and lighter periods for the past year as well. My last period lasted for literally 10 hours, and the ones before that 1-2 days at most. This is a big change for me, since they used to last for 5-6 days and were very regular.

I have never tried hormonal BC, and I'm curious about whether it might help, so I'll ask at my appointment. The fatigue is the worst symptom -sometimes I have to sit down urgently because I feel like I might pass out. In the morning I have zero energy, it feels like I have the flu every day when I get up.

For perimenopause there are no blood tests. We treat based on symptoms. Your symptoms sound definitely consistent with perimenopause with the change in menstrual cycle and now amenorrhea. Hormone therapy could definitely help. Hope you get some answers!

Thank you, this is reassuring!