Polycystic Ovary Syndrome (PCOS) affects up to 10% of women of reproductive age, yet many go undiagnosed for years. The right lab tests can provide crucial insights for diagnosis and management.
What Is PCOS?
PCOS is a hormonal disorder that can involve:
- Irregular or absent periods
- Excess androgen (male hormone) levels
- Polycystic ovaries on ultrasound
You don't need all three criteria for diagnosis - two of the three can be sufficient.
Essential PCOS Labs
Androgen Panel
- Total Testosterone: Can be elevated in PCOS
- Free Testosterone: The active form, which can be more sensitive for detecting excess
- DHEA-S: Adrenal androgen that may be elevated
Reproductive Hormones
- LH and FSH: LH/FSH ratio >2:1 can be common in PCOS
- Estradiol: May be normal or elevated
- Progesterone: Can be low due to anovulation
- AMH: Can be elevated in PCOS
Metabolic Tests
- Fasting Insulin: Insulin resistance can be common in PCOS
- Fasting Glucose and HbA1c: Screen for prediabetes/diabetes
- Lipid Panel: PCOS can increase cardiovascular risk
Thyroid Panel
Thyroid dysfunction can mimic PCOS symptoms and should be ruled out.
Understanding Your Results
PCOS is a syndrome, meaning it presents differently in everyone. Your lab results can help identify which type of PCOS you may have and guide treatment.
References
- Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. (2004). Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertility and Sterility, 81(1), 19-25. PMID 14711538
- Azziz, R., et al. (2004). The prevalence and features of the polycystic ovary syndrome in an unselected population. Journal of Clinical Endocrinology & Metabolism, 89(6), 2745-2749. PMID 15181052
- Legro, R. S., et al. (2013). Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology & Metabolism, 98(12), 4565-4592. PMID 24151290
