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How to talk to your doctors

How to talk to your doctors
Going in to see your doctors can be really daunting. There have been numerous times where I’ve been made to feel dumb, worthless and stupid for asking for blood tests for my hormones because they are ‘normal.’ Newsflash. I don’t want to be normal, I want my bloods to be amazing. Or as close to perfect as possible!

Firstly, the ranges for blood tests can be very broad. These ranges include all the people in the population that have crap hormones as well as good hormones so whilst you might be “in range,” it doesn’t mean that your hormones are optimal.

Doctors are trained in school to counsel you on the ‘most effective’ hormonal birth control so please don’t be alarmed if they try to put you on the pill or the IUD to “fix” your problem. Just an FYI, no hormonal birth control fixes anything. It shuts down your system and you will have to deal with the problem (and often the problem becomes 50 times as bad) later in life. And who wants to deal with worse acne than before when they are 30 and also trying to have a baby? Not me!

Also, if you say to your doctor that you are doing the Fertility Awareness Method as your birth control, chances are that they will say that it doesn’t work and you’ll fall pregnant. They are probably thinking of the Rhythm Method which is very different, which I will talk all about in another blog post.

Doctors will also often tell you that your hormones are fine and in range. Or in my case, they will just say ‘your Sex Hormone Binding Globulin is really high, you must be on the pill?’ to which I respond ‘no I’m not on the pill.’ And then she just says ‘oh okay’ ..... like um hello are you going to wonder why it is so high then?

Some readings like TSH are ‘within’ range but the range is really out. The TSH range in Australia is 0.5-4 however it really should be 1.5-3 and ideally sitting around the 1.5 mark and further away from 3.

Your Estrogen:

  • Day 3< 293 pmol/L
  • Day 14: 550-1284

and your progesterone in your luteal phase should be 47.7-79.5 nmol/L

Cortisol (serum) – optimal range is 275-413nmol/L in the morning

DHEAS (serum) - the optimal range is top half or normal range 200-380

Other things to note:

  • PCOS cannot be diagnosed by just an ultrasound and very often when you come off the pill you can have PCOS-like symptoms but these will go away with time.
    • There's actually 4 types of PCOS which I talk about in depth in my Turning Off Your Period Problems Program
      • Adrenal PCOS
      • Insulin resistant PCOS
      • Post-pill PCOS
      • Inflammatory PCOS
  • An insulin resistance cannot be diagnosed by a glucose test. It needs to be tested by 'fasting' insulin or a 'glucose tolerance test with insulin'
  • Do you have elevated Testosterone or another androgen such as androstenedione or DHEAS?
  • Progesterone needs to be tested. You want to see if you ovulated. Remember a progesterone test must be time to be about one week after ovulation or one week before your next period.
  • Iron - what is my actual ferritin reading? It should be greater than 50ng/mL
  • The pill bleed is not a real bleed
  • If they say the pill helps with bone health - research is actually showing that it DOESN'T
Remember ladies, that despite being an expert in this field, I still sometimes want to cry in the doctor's office because they make me (sometimes) feel so stupid. Many of my friends that are also experts in the health field have also been made to feel very dumb, so please don't get too worried if you do too! Remember to stand up for yourself and QUESTION THINGS! You know in your gut if something is wrong and there is NOTHING wrong with asking to get your bloods done! This blog post is a generalisation about doctors not listening to us.