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normal for ammenorhea to be undiagnosed after lab exams?

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Hello and sorry to ask the same questions again but last time I did not get them answered as I had hoped to.

The link to my last question is here.
http://ehealthforum.com/health/topic282315 .html.


I have already had numerous lab exams on my hormones, progesterone, estrogen, tsh, fsh & lh, etc., and pituitary gland. They all come out within the normal range except for the lh which is twice as the fsh and testosterone is elevated by only 5 points above the female range.
Now about PCOS it has not been diagnosed yet, just as I might have it the doctors say I may not have it. What I do know is that my glucose level is 80 and I have no acne and the MRIS and sonograms confirm no ovarian cysts--so honestly I feel PCOS is not my case.

My question is \
"So is it normal for ammenorhea to be left undiagnosed after lab exams?\" Has there ever been a case of unkonwn causes for this or is there always a cause? Please advice me on what I should do next.


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replied May 20th, 2011
Menstruation Answer A23193
Hi,
Welcome back to ehealthforum,
Thanks for the repeat query,
The cause for your amenorrhea is already established by your lab results showing high LH levels and raised Testosterone levels. You should have considered giving your lab results along with your previous query for more clarity. The surge of LH is responsible for ovulation along with surge in FSH. This LH after ovulation stimulates corpus luteum to produce progesterone. If this LH is not controlled and there is no feedback going from your ovary to the brain/pituitary (to be specific), then the gland keeps producing LH, and it results in amenorrhea. Isolated LH elevation along with increased Testosterone levels could suggest possibility of ovarian thecoma or secondary ovarian failure. Removal of this can result in normalization of your hormonal levels and return of periods. You might also need testing of adrenal hormones and karyotyping test to rule out other problems as responsible for the isolated elevation of LH and raised Testosterone levels. A special test for ‘Inhibin B-producing sex cord granolosa-stromal cell tumors’ should be considered in women who present with amenorrhea with isolated LH elevations, even in the setting of a previously normal pelvic ultrasound report. Discuss about these possibilities with your treating gynecologist. You may also consider taking a second opinion from another gynecologist and then proceed with further management. Hope this helps.
Take care.



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