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Polycystic Ovarian Testing Overview:

In order to gauge your current state of health, our clinic will often request copies of your last two years of medical testing and will often recommend further testing as needed.  Our clinic does request some testing that is and not commonly performed in more "mainstream" medical clinics.  24-hour heavy metal testing with provoking agent, neurotransmitter analysis, food sensitivity testing, comprehensive stool testing and Candida antigen testing are commonly recommended by our medical staff.   Some of these are discussed in detail in the links in this section.

What to Expect on Your First Visit:

First office visits typically last 45-60 minutes.  Your doctor will review your intake form with you and gather a detailed medical history.  A partial physical exam is usually performed and medical records are often requested from your primary care physician and/or other doctors.  Specialty laboratory testing may be recommended.  Most clients are offered an initial protocol consisting of nutritional supplementation, dietary and life style recommendations.

First Visit: Blood Test

To assess and identify kidney, liver, blood sugar and other key factors such as blood cholesterols. The results are explained to the patient, giving him/her a fuller understanding of the blood chemistry, so that they may take control.

Patients are required to fast for 14 hours before the test. Water may be drunk freely, but not tea, coffee, juices or other beverages. Appointments are normally arranged for mid-morning so that food and drink can be consumed up to 8pm the previous evening. On the day of the appointment, any prescribed medication should be taken with water as normal.

Patients are recommended to bring food to eat after the blood sample has been taken. Diabetics should advise the clinic, and separate arrangements will be made.

First Visit: Urine Analysis

To establish exactly how the kidneys are functioning. Patients are required to collect urine over a period of 24 hours. This should be as near the date of the blood test as possible, but must not include the 14 hours fasting period prior to the appointment.

A recommended timetable is that the first urine of the day should be excluded, than all subsequent urine for the next 24 hours collected in clean plastic containers. (If collection starts at 8am, this process must be followed until 8am the following day.) Eg. Appointment 10am Friday, fasting commences Thursday 8pm. Urine collection starts Wednesday 8am. until Thursday 8am.

Containers should be clearly labeled with the patient's names and brought to the clinic at the time of their appointment.

First Visit: Resting ECG for Doctors Report

The electrocardiograph (ECG) determines the condition of the heart and measures its actions and the pulse.

The doctor in charge reports any findings in his medical notes.

Specific Polycystic Ovarian Testing:

1. Pelvic Ultrasound

What is a Pelvic Ultrasound?

An ultrasound works by sending out high frequency sound waves, directed at the internal body part being examined, and recording the reflected sound or 'echoes' to create an image. The sound waves are emitted from a small, vibrating crystal in a hand-held scanner. The high frequency of the sound means it can't be heard by the human ear. An ultrasound scan doesn't produce high quality images, but it is non-invasive and doesn't involve radiation. It is commonly used to study the abdominal organs, pelvic organs and breast tissue.

A Pelvic ultrasound is an obstetric tool used to evaluate the genital tract for disease and to monitor known pelvic disease.

Indications and Contraindications

A pelvic ultrasound may be performed if a woman is suffering pain during sex, or has abnormal periods, fibroids, cysts or other conditions associated with the female reproductive system.

How do you prepare for a pelvic ultrasound?

An ultrasound scan doesn't require any special preparation beforehand. However, you may need to have a full bladder prior to the scan. It is recommended that you drink 2-3 glasses of water an hour before the test and to avoid urinating. If the ultrasound is to be done vaginally, no water is required before the examination. You will be advised by your doctor regarding this preparation. Items that may interfere during the ultrasound, such as jewelries and other metallic objects, must be removed before the test.

 

How does it feel? How long will it take?

An ultrasound scan usually takes around 15 to 20 minutes. This test is non-invasive, therefore it is painless. You will not feel anything at all, except for the cold feeling of the gel as soon as it is applied to your skin. In pelvic ultrasound, you might feel a little discomfort from having a full bladder and you might have the urge to urinate. Otherwise, you will feel very little to no discomfort during the test.

Expected effects after the test:

The ultrasound scan is a safe, non-invasive procedure that doesn't pose any known risks, side effects or complications to women and their babies.

Special instructions after the test:

After the procedure, you will be given paper towels (or something similar) to wipe off the gel. You can then get dressed. The scan itself is painless, drug-free and non-invasive, so there is no 'recovery time' needed. You can go about your normal business as soon as you've finished the scan.

Results:

Normal Findings:

• Absence of growth, cysts, tumors, and fluid
• Ovaries, uterus or fallopian tubes are normal in shape, size and position

Abnormal Findings:

• Abscess, kidney stones and pelvic inflammation (pelvic inflammatory disease)
• Abnormal growth of the endometrial lining of the uterus
• Presence of cysts, tumors and fluid
• Shape and size of the uterus appears to be abnormal

Notes:

• A lubricant is used for good transmission of sound waves to and from the body.
• Other names for ultrasound scan include sonogram and ultrasonography.
• You may be asked to hold your breath for a few seconds during the pregnancy ultrasound

2. Hormone Level Testing- Testosterone

What is a Hormone Level Testing -Testosterone?

A testosterone test checks the level of this male hormone (androgen) in the blood. Testosterone affects sexual features and development. In men, it is made in large amounts by the testicles. In both men and women, testosterone is made in small amounts by the adrenal glands; and, in women, by the ovaries.

Indications and Contraindications

A Hormone level testing for testosterone is used to evaluate male and female conditions such as:

• Precocious puberty
• Infertility
• Tumor marker for ovary and testicle tumors
• Ambiguous sex characteristics
• Decreased sex drive
• Erectile dysfunction
• Delayed puberty
• Irregular period for women

How do you prepare for a Hormone level testing for testosterone?

There are no special preparations required for this test.

How does it feel? How long will it take?

The hormone level test for testosterone is a painless procedure that usually lasts for a few minutes, about three minutes or less. Some patients may feel a slight stinging pain while the needle is being inserted into the vein on your arm to draw blood. After the test, a small amount of throbbing might occur on the needle site.

Expected effects after the test:

Normally, there are no major effects after the test. In most cases, patients may feel a little sore and slight bleeding may occur on the needle site. Bruising or swelling may occur.>

Special instructions after the test:

After drawing the blood, cover the needle site with a bandage and apply pressure on it for several minutes. If the site becomes swollen, do warm compresses few times a day. You may resume your regular diet and your daily activities after the test.

Results:

Normal Findings:

Normal levels of testosterone fall between 3-10 ng or 10-35 nmol/L (SI units). Levels in the same man vary according to time of day, season and exercise.

Normal levels of testosterone in women are less than 1 ng/mL (SI units).

In prepubertal boys and girls, normal levels of testosterone are 0.05-0.2 ng/ml (SI units)

Abnormal Findings

Increased levels of testosterone can indicate the following conditions:

Males:

• Hyperthyroidism
• Testicular tumors
• Encephalitis
• Pinealoma
• Congenital adrenal hyperplasia     

Females:

• Ovarian tumor
• Adrenal tumor
• Congenital adrenocortical hyperplasia
• Polycystic ovaries

Decreased levels of testosterone in males indicate the following conditions:

• Hepatic cirrhosis
• Primary and secondary hypgonadism
• Hypothalamic disease
• Pituitary disease
• Klinefelter's syndrome

Notes:

The testosterone levels in men usually decrease with age. They gradually begin to fall from the age of 40 years and decrease by approximately 0.3% per year. It has been estimated that up to 20% of men over 60 will experience a decline in androgen production that is significant enough to warrant a diagnosis of androgen deficiency.

It is necessary to draw the blood for testing testosterone levels early in morning because this is when the levels of testosterone are at its highest

The Right Diagnosis and Treatment Ovarian Cysts

Once the comprehensive review is completed for each patient, our doctors and our team of medical professionals will evaluate your diagnosis. At this point, our doctors will spend one on one time with you to interpret and explain your results. Together you will explore your goals and discuss your treatment plan options. These treatment plans can be implemented using multiple modalities such as medications, hormones, diet, supplements, behavior and lifestyle changes, and alternative therapies. Our doctors will prescribe a preventative and comprehensive treatment plan that is tailored to your needs and fits into your lifestyle.

Patients Medical's Personal Approach to Ovarian Cysts

Our doctors and our team at Patients Medical will regularly monitor your progress and track the effectiveness of your program making adjustments if necessary. Our goal is to support you and advise you every step of the way.

We work in conjunction with your existing doctors. Any gaps between specialists are filled to ensure we support your overall health and well-being. While we treat serious medical conditions such as Alzheimer's, Diabetes, Parkinson's, Multiple Sclerosis, anxiety, depression, and heart disease; the primary objective of our staff is prevention and early detection of disease.

We are located at: Patients Medical PC, 800 Second Avenue, Suite 900 (Between 42nd & 43rd Street), Manhattan, New York, NY 10017.