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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor
Category: Medical
Satisfied Customers: 62979
Experience:  MBBS MS. Post doctoral fellowship in Sports Medicine. General surgeon and sports medicine specialist
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I wanna speak to endo, hair, yes, slightly high cortisol

This answer was rated:

i wanna speak to endo
JA: What are all your symptoms? Are you taking any medication?
Customer: facial hair
JA: Got it. Have you seen a doctor about this?
Customer: yes
JA: Thank you so much for your time. Finally, is there anything else in your medical history you think the Doctor should know?
Customer: slightly high cortisol levels

Welcome to Just Answer.

Answers here are for education and information.

I will respond shortly with an answer or further information request.

What is your age?

Apart from cortisol levels were any other hormones abnormal?

What did your ultrasound of ovaries show?

Are your periods normal, have acne, overweight?

Customer: replied 13 days ago.
I have always had very little hair almost negligible on my chest and near belly button. I have never been on proper weight. Have always been either under or overweight. However, last year I started growing facial hair after gaining 10kgs weight and it's getting worst day by day affecting my mentall health.
Customer: replied 13 days ago.
My age is 25. periods regular and no acne

Thanks for the further information.

I am writing the answer for you and will get back to you in 3-5 minutes.

Unless you wish to speak in person, you can ignore the request for a phone call automatically generated by the website, not by me.

Thank you.

Customer: replied 13 days ago.
a gynaecologist told me that I have "pre pcos" and loosing weight might help. she said although I have regular periods at the moment but it might get irregular if I stay overweight
Customer: replied 13 days ago.
however, GP's have been just guessing idiopathic hirsutism and saying I have slightly elevated cortisol which might be the reason but they cant do anything about it only specialist can provide advise they said
Customer: replied 13 days ago.
howevr, waiting time for specialist is six months

The first step would be to get the following investigations, if not done;

1) androgen,

2) luteinizing hormone (LH), and

3) insulin

4) Ultrasound of ovaries.

The treatment is;

a) The drug of choice for inducing ovulation in PCOS is clomiphene citrate.

b) Metformin

c) Coming to optimum weight.

d) Laparoscopic ovarian drilling.

e) Spironolactone, flutamide and finasteride are antiandrogens that work in PCOS by decreasing androgen levels, thereby reducing the signs of hirsutism/abnormal hair. These antiandrogens may also improve lipid levels, which can be elevated in patients with PCOS.

Please feel free for your follow-up questions.

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

Customer: replied 13 days ago.
I just told you all my hormones are normal including testosterone

I was wondering if insulin was done.

Also differentiating feature of PCOS and PCOD is ovarian cysts.

If ultrasound is normal it is idiopathic hirsutism.

Customer: replied 13 days ago.
how to deal with idiopathic hirsutism?
Customer: replied 13 days ago.
no insulin was not done
Customer: replied 13 days ago.
my gp doesn't share my blood test results he just says everything is normal

Laser hair removal and spironolactone would help.

Customer: replied 13 days ago.
i dont have my ulta sounds at the moment but as far as i remember it said that it has cyst

Cysts, abnormal hair, and high cortisol would point to PCOS.

Customer: replied 13 days ago.
is it possible to have pcos even if periods are regular

Yes, it is possible.

Customer: replied 13 days ago.
i have noticed hair growth flairing up after consumin sugar or too much stress
Customer: replied 13 days ago.
is it possible pcos id causing abnormal hair growth although testosterone levels are normal?
Customer: replied 13 days ago.
also it is suspected that I might have pituitary macroadeonoma although my prolactin levels are normal.. so do you think that might be causing hair growth? Doctors have told me it's very small and they're not really sure if it is just bulging or tumor
Customer: replied 13 days ago.
File attached (Z4L27T5)

Macroadenoma may cause high cortisol and if symptoms are severe may need surgery.

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