| Preparing for Your PCOS Consultation: Questions to Ask Your Doctor Source: http://www.medem.com/MedLB/article_...ENC&sub_cat=502 Each time a woman visits her doctor for a PCOS consultation, regardless of whether it is her first visit or her tenth, she will have questions. What should I ask the doctor? Better yet, what should I tell the doctor? Which symptoms are pertinent and will help my doctor make an accurate diagnosis? The time spent with a physician usually is limited and therefore valuable. It is important to make the most of your visit. This article was developed to serve as a general guide, whether you are making your first trip to your doctor for a PCOS diagnosis or are a seasoned veteran. Take the suggestions that follow and tailor them to your specific needs. Finding a Doctor Choosing a physician can be a difficult process. Often, women are limited by health insurance plans or proximity to specialists. Before making a selection you may need to consult your insurance plan's guidebook. Question: How Do I Choose a Doctor? Your local PCOSupport Chapter is a good place to start. There, you talk with other women in your area who have real experience selecting a good doctor for PCOS. You can also consult the PCOS Association's Professional Membership Directory to see if there is a local member physician in your area. Other possible sources include your primary care provider and/or hospital network's referral services as well as the directories of such professional organizations such as the American Society of Reproductive Medicine and The Endocrine Society. Disclaimer: The information provided herein is simply intended to be a guide. It is not a comprehensive listing of specific treatment questions nor is it a recommendation of any particular course of medical treatment, medications or procedures. Starting to Find Answers ... Question: What Kind of Doctor Do I Choose? PCOS can be treated at many levels but generally is most effectively treated by a doctor who specializes in hormone disorders. Depending on the level of knowledge and expertise of your family practitioner or gynecologist, you may need a referral to a specialist such as an Endocrinologist or a Reproductive Endocrinologist (also referred to as a Fertility Specialist). Whether you choose an Endocrinologist or a Reproductive Endocrinologist (RE) depends on your circumstances and the resources in your area. If your goal is to treat your PCOS and get pregnant, then an RE is your best bet. If you have no interest in conceiving then your choice may depend on who is available in your area and whether or not your local RE treats women who are not trying to conceive. Some limit their practice strictly to fertility. Consider some of these questions when looking for a new doctor: How long is the wait for an initial appointment? Is there a specific physician in the practice who specializes in PCOS? How long has the doctor been in practice? Is there any type of up-front initial consultation fee or can my insurance be billed? Some patients may wish to ask even more detailed questions. However, you may find that many doctor's offices are unable to answer such questions over the phone and you may wish to save some of these questions for your initial consultation. What is typically done to confirm a PCOS diagnosis? Do you test for insulin problems such as excess insulin, insulin resistance or diabetes? If so, what tests are commonly used? In your practice, do you prescribe insulin sensitizing agents when indicated? Do you integrate or recommend natural or dietary therapies in treatment? Preparing For The Appointment Question: What Do I Tell My Doctor? PCOS is comprised of a broad constellation of symptoms. Because of that, it is sometimes hard to know if your particular symptoms are pertinent or not. If you have any of the following symptoms, mention them to your doctor. They may be helpful in making your diagnosis. __ Irregular cycles: no periods, few periods or excessive bleeding __ Excess facial or body hair, specifically, hair on the face, neck, breasts, chest and abdomen that has become darker or thicker over time __ Acne __ Sudden unexplained weight gain, especially which coincides with stopping hormone therapy such as birth control pills or other contraceptive medications such as depo provera and norplant __ Difficulty keeping weight down __ Feeling dizzy or light-headed and losing concentration or emotional control two or more hours after a meal __ Darkened patches of skin on the neck, groin, under arms or in skin folds __ Skin tags __ Elevated cholesterol, especially LDL, and/or triglycerides __ Family history of diabetes or heart disease __ Depression or anxiety Although some of these items may seem unrelated, they are important to disclose to your doctor. The more we learn about PCOS, the more that we realize the scope of the effect it has on overall health. At the Appointment Question: What Do I Bring With Me? Make sure to bring along a list of all the symptoms that concern you. If you have any additional symptoms not mentioned above but which worry you, don't hesitate to bring them up. It is best to give your doctor as much information as possible and then let him or her decide which items merit consideration and/or treatment. When you go to your appointment, you may have a long list of questions for your doctor. Try not to immediately overwhelm him or her with your questions. Give your doctor a chance to get to know you by taking a complete medical history and performing a physical exam. You may find that many of your questions are answered throughout the course of the consultation. After the Appointment Once you have visited with your doctor, you may want to assess your experience. If so, ask the following questions. These questions are also a great way to assess your relationship with your current physician. How well are you treated when you see the physician? If you bring information to your appointment, is your doctor receptive? Do you feel comfortable with this person? If not, consider choosing a doctor who is younger, older or a different sex. If asked, would you be able to recommend your doctor wholeheartedly? If you hesitate, why? Trying to Conceive? Question: What If I Have PCOS And Want to Get Pregnant? Women with PCOS who are trying to conceive have special questions all their own. Here are some questions you may wish to consider asking your physician before or during your consultation. Again, try not to overwhelm the doctor with questions right away. Many of your questions will be answered through the natural course of the consultation. What do you usually recommend for women with PCOS who are trying to conceive? Do overweight women with PCOS need to lose weight before you will treat infertility? How many cycles of clomid do you typically prescribe, and at what dosage? If I need to have specialized fertility treatments, such as intrauterine insemination (IUI) or in vitro fertilization (IVF), can your office do that? What monitoring is done before and after pregnancy occurs? Would you add or stop any medications once pregnancy occurs? When is your office open for monitoring? Can I be treated, if necessary, on weekends and holidays? Do you treat PCOS in the postpartum period and after? If so, what do you usually recommend? |