Monday, March 30, 2009

Cushing's Syndrome in Women With Polycystic Ovaries and Hyperandrogenism



Cushing's Syndrome in Women With Polycystic Ovaries and Hyperandrogenism continues the theme of how to distinguish between PCOS and Cushing's. Above is a picture of a woman who was diagnosed as having PCOS. 7 years later, she was re-tested and found to have Cushing's Syndrome instead.

Cushing's patients are frequently misdiagnosed with PCOS. It is an easy diagnosis (in layman's terms) and avoids the multiple tests and confusion which suspicion of Cushing's seems to bring. This article talks about the aforementioned case and 3 others where Cushing's was misdiagnosed as PCOS. Once treated for the Cushing's, all symptoms which had been attributed to PCOS resolved.

The authors make the case for "the diagnosis of PCOS only when other etiologies have been excluded." They also contend " economic pressures drive health care to be delivered within fewer consultation sessions outside of specialist centers [making it] pertinent to emphasize that not all cases of hyperandrogenism or ovarian cysts are related to PCOS and that curable causes, such as Cushing's syndrome, must be excluded by careful history taking, examination and (potentially repeated) investigation."

And, as a sidenote, the authors mention screening patients who have type 2 diabetes. According to them, "Recent data obtained by screening individuals with type 2 diabetes suggest that cortisol excess, widely considered a rare endocrinopathy in the form of classical Cushing's syndrome, is in fact more common than supposed. "

6 comments:

  1. mmm .. cushing's syndrome, well now I know what the differences. Thanks

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  2. i have been taking treatment for pcos from past one year.my periods r regular as long as iam on treatment,once i discontinue my periods r irregular again.hw do i knw if i have pcos or cushings

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  3. The name of your blog seems to find its way into my life every day because if I survive this journey it will be a miracle in itself, living ina part of canada, a province that dont even have an endocrinolgy floor, in its only major hospital tells you what I am up againist..if not for women like you who have shared the knowledge on your journey, women like me would not even have a chance at life..and I cant help but to wonder how many of them die..while looking for answers..pcos..has been throwed at me many times, even with an ultrasound showing a tumor on my adrenal glands..in my mid 20s when I first lost my hair, and was suffering bad from mental health symptoms, and now with two tumors one on each adrenal gland..adrenal hyperplasia on one, and positive salvias..they are still throwing pos at me, as a diagnosis, and questioning adrenal cushings..I read marthas story, I cried, I cry every day..for how little respect women get with this..illness..how many lifes, have been destroyed and lost..to it..how such a lack of research goes into it..even wehn it is right before a endos eyes in black and white..they still dont get it....thank you for this article and so much more you offer the cushings commmunity..

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  4. I have also been treated for pcos with metformin and now my pcos told me that the blood work I took 6 months ago should signs of Cushing's syndrome and is now sending my to a endocrinologist but my ob/gyn was treating me for pcos. Dr's just write scripts to shut us up but do more questioning and get to the route of your problems

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  5. Hi, Anonymous. I agree. Many doctors do just that. It is worth the effort to find one who doesn't. I had to doctor shop for years.

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  6. this is exaclty the confusion I am battling right now for my daughter. I want the right diagnosis. Most MD's, even endocrinologists have never seen a live case of Cushings. So unless it is really advanced and has ALL of the obvious markers they miss it. What is the best way to find the right doctor if you suspect Cushings?

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