You're very welcome!
Lemme see what I can offer here!
At first blush, I definitely thought of PCOS because you mentioned the high testosterone levels, so I looked up hormone levels associated with PCOS. Some of yours seem to fit and others don't. It appears that PCOS usually makes DHEA-S too high, rather than too low.
Other than that, PCOS doesn't technically cause high levels of estrogen... but, it kind of can indirectly. I don't want to sound rude or anything, but are you overweight? I am, so I'm totally not in any position to judge you... LOL... but it would possibly help me answer your question.
If you are, and if by even a reasonably significant amount, the extra estrogen can be produced by an excess of fat cells. Fat produces estrogen and often causes women with PCOS to have high estrogen levels. The extra weight is commonly caused by insulin resistance, which is very commonly associated with PCOS. It's slightly akin to diabetes, but instead of the body not producing insulin, it just doesn't process it correctly. The symptoms are similar to that of diabetes in some cases, and it is treated orally with diabetic medication (not injections).
The level of your progesterone really doesn't say much, because it should be taken at certain specific times throughout your menstrual cycle to make the correct determinations. The major reason would be to confirm or deny ovulation. Do you know if you ovulate regularly?
Were I a medical professional and your gyno, I would do bloodwork to determine your reproductive-related hormone levels throughout your cycle to get a full picture of what you have going on, rather than a snapshot of your levels at this one specific moment in time but unrelated to your levels at other times. I would also ask that you not eat for at least 8 hours before your appt with me so that I could perform a fasting blood glucose test to check for insulin resistance.
If you are suspected to have PCOS (the high testosterone is so commonly indicative of PCOS that your doctor might just to it like I did), you will likely be put on Avandia (less common) or Metformin/Glucophage (much more common). The dosage will probably be low to start with... maybe 500mg/day for the first month, and then slowly working your way up to 1000mg/day or even 1500mg/day. Clinical studies have not found it to be effective in dosages less than 1500mg/day, but there are some unfortunate gastro-intestinal side effects that accompany taking too much of it too quickly. The issues do tend to subside after about a week if you can stick it out, but it can be fairly unpleasant especially in the first few days... think deep stomach groaning noises with gastro-intestinal cramping and (no good way to say this) liquid bowel movements... not just loose, but LIQUID! You likely won't have trouble making it to a bathroom, but you might have to find one pretty quickly. This is intensified with the consumption of complex carbohydrates, sugars, and sometimes vigorous exercise. The side effects are generally more common when you begin taking a higher dose rather than working up to it... ya know, starting with 1500mg/day like I did wasn't the best idea, but mine was un-prescribed when I started taking it.
If he suspects that you have PCOS, he will also possibly send you for a trans-vaginal ultrasound of your uterus and ovaries. Poly-cystic ovaries are pretty easy to pick out on an ultrasound. They kind of look spider-webbed, like this. The appearance is caused by follicles that begin to mature each month and then fail to burst at ovulation, so they have MANY follicular cysts that shouldn't be there anymore but remain anyway. The Metformin will help to control the possible insulin resistance, which will help to relieve other symptoms, such as aiding in weight loss when the glucose is being controlled, which leads to less estrogen-producing fat, which leads to less estrogen... which is GOOD!
He likely won't prescribe much more than that initially. The tests should really come first. But, Metformin will NOT hurt you to take it even if you do not have PCOS or insulin resistance (also called "metabolic disorder").
You will likely be asked to try for another couple of months with only the Metformin. That is sometimes enough to allow conception within a few months for women with PCOS.
The next step is almost always Clomid for 3-6 months (or until
if that comes before the 3 or 6 month mark) depending on your doctor. It's best to be monitored while taking it (cd12 ultrasound to check for follicle # and size, cd21 bloodwork to confirm or deny ovulation, end of cycle ultrasound to verify that there are no ovarian cysts before the next cycle). Most reproductive specialists do this monitoring and many ob/gyn's do not... though some do. Clomid is a mixed bag... it slightly increases your chances of multiples but not ridiculously so. It can have some nasty side effects, but many women don't experience any side effects or only VERY mild ones.
I'm sorry that your gyno is a pr*ck. Hopefully he's pretty familiar with infertility and the treatment thereof? If not, you should probably push for a referral to a fertility specialist if you have insurance that covers it or can afford it.
I hope that helps?
Good luck, hun!
~*BABY DUST*~
xxxx
