I am 23 years old and have been gaining a lot of weight over the last three months (46 pounds). Also, I do not ovulate and only have a period when I'm on the pill. My TSH levels are normal, but my testosterone runs high. My doctor will not listen to me about the weight -- he thinks I just eat too much, and in two years he has not found out why I don't ovulate. I read that a lack of progesterone could cause symptoms like mine. What do you think might be the problem?

--Debbie

Actually, your symptoms sound an awful lot like polycystic ovarian syndrome (PCOS). Hallmarks associated with PCOS include menstrual irregularity or even lack of periods altogether, increased facial and body hair, obesity, infertility, insulin resistance and diabetes, elevated androgen (male hormone) levels and elevated luteinizing hormone levels. Not all women with PCOS have all of these signs and symptoms.

The treatment for PCOS usually involves suppressing the high circulating androgen levels, most often by using birth control pills. If you have insulin resistance, adding an oral diabetes medication like Glucophage can help. Some medications that block the action of testosterone can improve acne and lessen unwanted hair growth. If you are obese, weight loss may help decrease testosterone and other androgen levels; spontaneous ovulation may occur once you lose 10 percent of your body weight. If you are trying to become pregnant, then you may need medications like Clomid to induce ovulation.

Such a rapid weight gain is not normal, and besides PCOS, other, more serious conditions may cause it. These include an adrenal tumor or Cushing's disease. I recommend that you see an endocrinologist. A reproductive endocrinologist can evaluate you for PCOS, and if that does not seem to be the problem, a medical endocrinologist can work you up for other conditions.