Polycystic ovarian syndrome (PCOS) is a health condition caused by hormonal imbalance that affects women of the childbearing age. PCOS is one of the leading causes of infertility in women and the problem with this disease is that its diagnostic criteria are still not clear. No single specific test can diagnose polycystic ovarian syndrome. The doctor will discuss your medical history; run a physical exam along with some blood tests in order to diagnose polycystic ovarian disease. PCOS is diagnosed when there is an overproduction of androgens (male hormones), absence of ovulation in the ovaries and presence of multiple cysts in the ovaries.
Important Exams and Tests for PCOS Diagnosis
Diagnosis tests for PCOS involves lab tests, physical exam, medical history and ultrasound.
The doctor may recommend a number of blood tests in order to measure the levels of several hormones. These tests help to rule out other possible causes of menstrual abnormalities. Blood tests also assess the levels of androgens in the body.
FSH or Follicle Stimulating Hormone is tested to evaluate fertility issues, access the functions of the ovaries along with pituitary function. The level of FSH is usually low in case of PCOS. For this test a blood sample is drawn from your arm. Although, no preparation is required for the test but the timing of the test is usually correlated with the patient’s menstrual cycle.
LH or Luteinizing Hormone is tested to evaluate pituitary functions, evaluate fertility issues and to detect the release of an egg from the ovary. The level of LH is usually elevated for PCOS patients. A blood sample is drawn from the arm. No special preparation is required for performing the test, but the timing of the test is correlated to a woman’s menstrual cycle.
The testosterone test helps to detect abnormal testosterone levels in females which in turn help to diagnose tests for PCOS(polycystic ovary syndrome) and other causes of infertility. Testosterone levels are usually elevated for those with PCOS. A morning sample is preferred for this test. The blood sample is drawn from the patient’s arm.
This test is done to measure and monitor the estrogen level of the patient. An abnormal level of the hormone or hormonal imbalance is a sign of infertility. The level of estrogen may be normal or elevated for those suffering from PCOS. A blood sample is taken from a vein in the arm.
Sex hormone binding globulin (SBGH):
This test is done to measure the evaluation of women with signs and symptoms of excess male hormones (androgens). This tests is suggested when the symptoms of increased or decreased total testosterone measurement seem inconsistent with the symptoms. The level of SBGH may be reduced in case of PCOS. No special preparation is needed for the test. The blood sample is taken from a vein in the arm.
This particular test helps to evaluate the functions of the adrenal gland. It evaluates androgen production along with ovarian functions. This test is recommended when some specific symptoms of PCOS such as hirsutism (excess body and facial hair), acne, amenorrhea (absence of monthly periods) or infertility is noticed. The level of androstenedione is usually elevated in a person affected by PCOS. The blood sample is taken from a vein in the arm. In case of menstruating women, the sample is to be collected one week before or after the menstrual period.
Human chorionic gonadotropin (hCG):
This test is done to confirm a pregnancy or identify an ectopic pregnancy. One of the main reasons for absence of periods or missed periods is pregnancy. The hCG test helps to rule out the chances of pregnancy. For this test an early morning urine sample or a blood sample is collected.
Anti-Müllerian hormone (AMH):
This test is done in order to evaluate ovarian functions and fertility, diagnose polycystic ovarian syndrome and understand the effectiveness of ovarian cancer treatment. For this test a blood sample is drawn from the arm. An increased level of AMH is often seen with PCOS.
Other than the blood tests an ultrasound of the pelvis, ovaries and uterus is also done in order to identify if there are cysts on the ovaries and if an ovary is enlarged. In PCOS, the ovaries can become 3 times larger than normal and can have 12 or more follicles per ovary. The cysts are often lined up on the surface of the ovary, appearing like a string of pearls. An ultrasound helps to visualize the changes in the ovaries. In most cases, an abdominal scan is done, in which the ovaries are viewed from the outside through the stomach wall. But a transvaginal ultrasound is more effective because it produces a clearer picture compared to an abdominal ultrasound. The transvaginal ultrasound is a painless procedure in which a pen-shaped probe is inserted into the vagina. An ultrasound sensor is present on the tip of the probe. Transvaginal ultrasounds can be performed only on women who have been sexually active.
Thorough physical exam is done as a part of PCOS diagnosis. During the physical exam the doctor will check your thyroid gland, skin, hair, breasts and belly along with a blood pressure and body mass index (BMI) check.
The doctor will also check and review your medical history as a part of the PCOS diagnosis. The review will include questions about your symptoms – change in weight, skin, hair and menstrual cycle. He may also ask you about the problems you faced with getting pregnant, the medicines that you are taking at present, your food habit and exercise habits. He may also inquire about any family history of hormonal problems.
Proper diagnosis is the first step towards PCOS treatment. These tests not only helps the doctor to evaluate the disease, but also aids to rule out other possible causes that show PCOS-like symptoms such as ovarian tumors, adrenal hyperplasia, etc.