possible hormonal problems?

[alriune]

i have a suspicion that some of the issues with my body, sexual and otherwise, may be contributed to by a possible unidentified hormonal problem. i've been talking to my therapist (who is getting her phd in sex therapy, though that's not the only reason i see her) and she definitely seems to think so, she said some of the issues i've been having are very very similar to when she had low testosterone.

i know that the people here probably aren't doctors and can't diagnose me over the internet, but i do know that the mods and admins have backgrounds in sex education and sexual health, and right now im just looking for guidance

my evidence for a hormone problem:

- irregular, sometimes absent periods. if i don't take birth control they completely disappear. when i was 13 i had brain surgery and after that i stopped getting periods and had to be put on birth control to induce them

- before birth control, my periods would be heavy and painful

- the women on my mom's side of the family have a history of hormonal issues. i forgot what exactly my mom's diagnosis is but she does (or did, when she was younger) have hormonal problems and had lots of trouble conceiving. i believe my grandma (her mom) also has similar issues.

i also have physical and mental symptoms that would be in line with a hormonal problem, but they can also be explained by other issues. those being:

- depression
- fatigue
- musculoskeletal pain with seemingly no cause
- forgetfulness
- brain fog
- mood swings

as i've mentioned in other threads of mine, i don't feel any pleasure from orgasm and my research suggests it could be an issue with dopamine receptors but most research has been focused on cis men. the one mention of a cis woman with the same issue was about it being alleviated with treatment for vaginismus (which i probably have). however, i have little issue getting aroused or orgasming.

i think my therapist is onto something but i don't have a good idea of where i would start with getting to the bottom of this, specifically finding a doctor who can run the right tests. the only ideas i have are trying to search for an endocrinologist but i don't know where to start or meeting a neurologist since i suspect having a brain tumor during puberty might have thrown off my body (i have dysautonomia as a result of said tumor so i think it could be a possibility, but the tumor wasn't located anywhere near any hormone glands) and i was already planning on seeing one anyway.

[Latha]

Hi Alriune,

I think that you've made a lot of observations that could really help a doctor figure out what is happening with you. I understand how you're confused about where to start finding a doctor- navigating the medical system can be very difficult. I think that you're on the right track in thinking about seeing a neurologist or an endocrinologist. Another possible suggestion is to see a gynecologist- it is useful to see one regularly anyway, just for checkups. The symptoms that you're experiencing may have more than one cause, so you may have to see more than one doctor.

So, how can you find a doctor? If you have insurance, I would recommend looking into the doctors who are covered under your plan and who are based near where you live. Check their reviews as well- this should narrow down the list a bit. You could also ask a primary care physician to refer you to some specialists.

If you can, try to find out what conditions your mother and grandmother had- that could be useful information. Also, try to keep your medical records on hand. Make a list of these observations and questions that you have, so you can discuss them when you see the doctor.

[Heather]

Hey there: since you're in the US healthcare system, the most efficient -- and most likely to be covered by your insurance or public health -- way for you to get the right healthcare for this would be for your therapist to share this information with your PCP (primary care provider), and then THEY can order what tests they can run and feel are needed as well as do any referrals they determine you might need to specialists. Often we can't make appointments on our own with specialists in the first place, and if we do we can wind up having to pay for them out of pocket which can be very, very expensive.

With the symptoms you are reporting, I would also schedule a visit with your PCP expressly to talk about those symptoms. There's a lot of basic bloodwork -- hormone screens with some of these would usually be way down the line, in my experience, since with some of them, other things would be both more likely and also more emergent to need treatment, like if you needed care for anemia, for example -- they could do right in a general visit. I would say these symptoms need investigating by a *physical* healthcare provider working within the scope of their practice, no matter what.

No shade to your appreciation for your therapist, nor any discounting the sometimes great value of community sourced health information, but a care provider doing a really good job with stuff like this would not be giving you maybe diagnoses based on their own experiences, they'd be trying to direct you to the care providers who could actually evaluate this. She knows this is outside the scope of her practice, surely.

Do you have a primary care provider already, someone or a practice you see for things like vaccinations and general care? If so, that's where to start, both for you and your therapist in sharing this info to facilitate any needed care.