A single test cannot diagnose PCOS thoroughly. Your healthcare advisor may prescribe you a list of blood tests, a physical exam, and an ultrasound to study the condition and to evaluate metabolic and hormonal imbalances.
A physical exam includes the observation of excessive hair growth, weight changes, acne, and insulin resistance. On the other hand, an ultrasound helps the doctor to check the condition of the ovaries and the thickness of the uterus lining. Lastly, blood tests will check the parameters for understanding hormonal conditions.
With the help of your test reports, your doctor will analyse hormone levels and the extent of your menstrual issues. Here are some tests that your doctor might suggest you get:
TSH Test
The TSH, aka thyroid stimulating hormone, measures your thyroid gland function. Symptoms of thyroid disorder are similar to PCOS, so the test checks whether the thyroid gland is working fine. Doctors prescribe this TSH test to check out other problems that are contributing to PCOS symptoms.
Thyroid disorders can exacerbate PCOS symptoms, so it is crucial to get checked and take proper treatment for the thyroid if required. Generally, most women with PCOS have normal TSH values i.e. 0.4-3.8 ulU/ml. If anything is wrong with the thyroid test measures, your healthcare adviser will guide you accordingly.
Testosterone
Women with PCOS have a high elevation of testosterone. Due to high testosterone levels, women with PCOS experience excessive hair growth on the face and body, acne, and weight gain. Although physical symptoms may point to elevated testosterone, it is better to get a testosterone blood test.
Testosterone tests can measure the value of total testosterone and free testosterone levels. Total testosterone tells the total amount of testosterone in your body whereas the free testosterone level indicates the small fraction of testosterone active in the body. The normal range of total testosterone levels is 15-70 ng/dL, and the free testosterone level is 0.7-3.6 pg/mL.
Prolactin
Prolactin is the hormone released by the pituitary gland. Its primary function is inducing lactation. However, elevated levels of prolactin can cause irregular periods or lack of menstruation. It is crucial to undergo a prolactin blood test to find the root cause of irregular menstruation.
Generally, doctors prescribe thyroid tests because untreated hypothyroidism can cause a rise in prolactin levels. If high levels of prolactin hormone show up in the prolactin test result, doctors might suggest an MRI of the pituitary gland to check for pituitary tumours (don't worry, these are rare).
Glucose Fasting
The fasting glucose test measures blood sugar levels and estimates insulin resistance. Fluctuation in blood sugar levels is one of the common issues in women with PCOS. Extreme sugar levels are a risk factor for type 2 diabetes. However, doctors prescribe an oral glucose tolerance test (OGTT) to screen glucose intolerance. The normal range of fasting blood glucose levels is less than 5.7 mmol/L.
To undergo a glucose fasting test, you should start preparation three days before the test. Eat three healthy meals and snacks for three days before the test. Avoid heavy eating and exercise 12 hours before the test.
Luteinising Hormone
The luteinising hormone (LH) test measures the LH level in the blood. The pituitary gland releases the luteinising hormone in women. The function of luteinizing hormone in females is to trigger egg release, a process called ovulation. However, in women with PCOS, the balance between LH and FSH (follicle-stimulating hormone) is usually disrupted.
If the ratio of LH and FSH is elevated, it results in an irregular menstrual cycle. Elevated levels of LH hormone are an indicator of PCOS. That's why doctors prescribe LH tests to understand whether LH is contributing to PCOS symptoms.
Follicle Stimulating Hormone (FSH)
FSH is a hormone that helps stimulate the growth of egg follicles within the ovary. It is responsible for the growth and development of ovarian follicles. Follicle-stimulating hormone blood tests help evaluate the FSH-LH ratio and ovarian function, which is crucial for PCOS diagnosis.
In a typical menstrual cycle, the FSH and LH ratio is balanced, whereas in women with polycystic ovaries the LH to FSH ratio is often higher – for example 2:1, or even 3:1. The FSH test is crucial to understanding the changes in this FSH-LH ratio and the FSH levels in your blood. Your doctor will recommend proper treatment if any hormonal irregularities are noticed in your reports.
Insulin Fasting
The fasting insulin test is recommended to measure insulin levels to detect insulin resistance, which is very common in PCOS patients. It is a simple blood test that measures the level of insulin in your blood after fasting. Fasting insulin levels are related to insulin resistance better than fasting glucose levels. However, preparation is required for this blood test. You can have three meals on the day before the test but please stop eating anything just 12 hours before the test.
