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Know all about the right tests to diagnose PCOS

The right kind of the diagnosis for PCOS is important to determine severity of the syndrome and the corrective actions that can be taken there after

Usually, the prognosis of PCOS begins when you experience the following conditions

  1. Irregular periods – it is important to keep a check on the routine of the periods cycle. Usually, teenage girls take some time to adjust to the regularity of the periods after menarche. So, give it sometime of around 6 months to settle before you are sure of the irregularity. Keep a watch on the cycle and if it occurs every month from 21 to 35 days it should be considered as a normal cycle. If at all the periods are delayed by 2 consecutive months or more then it an alarming sign.
  2. Sudden weight gain
  3. Acne
  4. Hirsutism- hair in the chin area or other parts of the body
  5. Darkening around the neck area
  6. Sudden cravings for sweets
  7. Mood swings, depression or anxiety
  8. Thinning of hair or hair fall
  9. Heavy periods or pain in the pelvic area after the periods
  10. Sleep issues
  11. Frequent headaches

If you find more than 5-6 symptoms at one time then you can consider visiting a gynecologist


Your doctor is likely to start with a discussion of your medical history, including your menstrual periods and weight changes.

 A physical exam will include checking for signs of excess hair growth, insulin resistance and acne.

Your doctor might then recommend,

A pelvic exam – The doctor will visually and manually inspect your reproductive organs for masses, growths or other abnormalities.

Blood tests – Your blood will be analysed to measure hormone levels. This testing can exclude other possible causes of menstrual abnormalities or androgen excess that mimics PCOS.

An ultrasound – Your doctor checks the appearance of your ovaries and the thickness of the lining of the uterus.

Let’s understand about these tests, a little more in detail.

Hormonal Blood Tests

A handful of blood tests are ordered to assess the level of various hormones in your body.

  1. Blood tests for have hyperandrogenism (high androgen levels).
  2.  testosterone and
  3.  free androgen index (FAI)

Other blood tests that can be useful in identifying high androgen levels include (done in specific cases – less frequent)

  • sex hormone-binding globulin (SHBG)
  • dehydroepiandrosterone sulphate (DHEAS)
  • androstenedione
  • insulin resistance
  •  fasting sugar
  • Post prandial sugar
  • HB1AC
  • Insulin hormone

Further diagnosis includes HOMA IR

  • Thyroid dysfunction
  • T3
  • T4
  • TSH
  • female reproductive hormone levels
  • oestradiol (oestrogen, the main female sex hormone)
  • follicle-stimulating hormone (FSH)
  • luteinising hormone (LH)
  • prolactin
  • Lipid profile
  • Inflammation
  • C reactive protein

Other tests for ruling out nutritional deficiency

  • Hemogram
  • B12
  • D3


An ultrasound might be carried out to provide images of the uterus, ovaries and pelvis. The image shows whether there are any ‘cysts’ (partly developed eggs) in your ovaries, and if the ovary is enlarged. It is also useful to assess the lining of the womb (endometrium), which may become thickened if periods are irregular.

You may have to undergo two types of ultrasound tests.

1. Transvaginal ultrasound

Transvaginal means ‘through the vagina’. In this ultrasound, a small pen-shaped probe is inserted in the vaginal canal and is gently moved to visualise different internal reproductive organs.

This type of ultrasound produces a much clearer picture than an abdominal ultrasound. It helps to see if there is any abnormality in the uterus, endometrium (lining of the womb), fallopian tubes, ovaries, bladder or the pelvic cavity.

Transvaginal ultrasounds are preferred to be performed on women who have been sexually active, otherwise only an abdominal scan is done.

2. Abdominal ultrasound

In this, the ovaries are viewed from the outside through the abdomen.

During the ultrasound, the doctor will check for cysts in your ovaries and how thick the lining is in the uterus. The inner lining of uterus may be thicker than normal if your periods aren’t happening ontime when they’re supposed to.

Your ovaries may be 1½ to 3 times larger than normal when you have PCOS. The ultrasound can show changes in the ovary in about 90% of women who have PCOS.


An ultrasound may not be needed if periods are irregular and there are already signs or measurements of high levels of androgens, and the woman is aged less than 20 years.

If there are more than twelve small cysts (which also string together like pearls) with a diameter of two to nine millimetres, the diagnosis of PCOS is made.

After the Diagnosis

Assessing your risk of developing cardiovascular (heart) disease and diabetes is important when testing for PCOS because there are established links found between PCOS, insulin resistance and being overweight.

Tests to assess these risks can include –

Lipid profile – This checks your cholesterol and triglycerides.

Glucose test – This helps to see if you have diabetes. More than half of women who have PCOS also develop diabetes. Your doctor may want to find out how well your body responds to insulin, which helps control your blood sugar level. If your body doesn’t respond to the insulin it’s making, you may have insulin resistance.

Blood pressure.

Frequency of These Tests

If you have PCOS, you will need a cholesterol and diabetes test every 1-3 years, and a blood pressure check every year. If you have risk factors such as a family history of diabetes or previous abnormal cholesterol tests, you will need these tests more often.

Rest assured, your doctor will work with you to manage your PCOS symptoms and help you get rid of it in the best possible way.

PCOS can be revered with lifestyle modification


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