Blood tests for testosterone and free androgen index (FAI) can identify high androgen levels. You may also have blood tests to check the levels of other reproductive hormones that affect your periods.
There's no single test that, by itself, shows whether you have polycystic ovary syndrome, or PCOS. Your doctor will ask you about your symptoms and give you a physical exam and blood tests to help find out if you have this condition.
Normal AMH levels range between 0.7 ng/mL to 3.5 ng/mL. Levels below 0.3 ng/mL are considered low and indicate that lower numbers of eggs are within the ovary and decreased fertility. Levels above 5.0 ng/mL are high and can indicate PCOS.
The best time to do this test is on day 3 of your cycle (day 1 is your first day of bleeding) — this is when your results can be accurately interpreted. If you have irregular periods — we recommend waiting until you have a period to get the most useful insights from this test.
As previously stated, the shape of a PCOS belly differs from other types of weight gain. It often appears large and bloated but can also be small and round, depending on genetics and other factors. The PCOS belly involves the accumulation of visceral fat in the lower abdomen and typically feels firm to the touch.
JC: Your symptoms can be vague or mimic symptoms of other conditions, so PCOS can go undiagnosed for a while. There's no single test for it, but a physical exam, ultrasound, and blood tests can help diagnose PCOS.
Women with PCOS usually have low to normal levels of FSH, but high levels of LH. Because LH is already high, there is no LH surge that occurs. Without an LH surge, the ovaries cannot release an egg and you may have irregular menstrual cycles.
He or she also will ask you whether you have a mother or sister with PCOS or with symptoms like yours, as PCOS tends to run in families. Conduct a complete physical exam. Your health care provider will do a physical exam and look for extra hair growth, acne, and other signs of high levels of the hormone androgen.
There are four types of PCOS: Insulin-resistant PCOS, Inflammatory PCOS, Hidden-cause PCOS, and Pill-induced PCOS.
Other disorders that mimic the clinical features of PCOS should be excluded: thyroid disease, high prolactin levels, and non-classical congenital adrenal hyperplasia. Large ovaries with many small follicles (which look like cysts, hence the name "polycystic"). These follicles are not cancerous.
High levels of estrogen are known as estrogen dominance and can occur in women with polycystic ovary syndrome (PCOS). This condition is a hormone imbalance that can cause irregular periods, unwanted hair growth, and acne.
Hormones in PCOS
Further complicating the issue, some women who have PCOS have persistently high levels of LH or multiple hormonal peaks. These factors can make ovulation testing all the more challenging in women with PCOS since the tests work by detecting surges in LH levels.
FSH, LH and oestradiol should be checked early in the menstrual cycle (day two – six, where day one is the first day of menstruation). Elevated FSH suggests reduced ovarian reserve and the possibility of impending premature ovarian failure.
Your GP will ask about your symptoms to help rule out other possible causes, and check your blood pressure. They'll also arrange for you to have a number of hormone tests to find out whether the excess hormone production is caused by PCOS or another hormone-related condition.
Ultrasound. Your doctor or specialist may perform an abdominal ultrasound to check for signs of PCOS (e.g. partly-developed eggs on your ovaries, enlarged ovaries or a thickened uterus lining). A transvaginal ultrasound may be used on women who are sexually active.
Diagnosis of polycystic ovary syndrome
Your GP will ask about your symptoms, your periods and your medical history. They will look for signs of polycystic ovary syndrome (PCOS) and try to rule out other conditions that can cause similar symptoms (for example, diabetes). You may need to have some of the following tests.
FSH/LH Blood Test.
Medications effective for weight loss (in addition to lifestyle modifications) that have been specifically studied in women with PCOS include metformin, acarbose, sibutramine, and orlistat (Xenical). Metformin is probably the first-line medication for obesity or weight reduction in patients with PCOS.
low levels of sex hormone-binding globulin (SHBG) – a protein in the blood that binds to testosterone and reduces its effect. raised levels of prolactin (only in some women with PCOS) – a hormone that stimulates the breast glands to produce milk in pregnancy.
Insulin levels build up in the body and may cause higher androgen levels. Obesity can also increase insulin levels and make PCOS symptoms worse. PCOS may also run in families. It's common for sisters or a mother and daughter to have PCOS.
A sufficient amount of estrogen is needed to work with progesterone to promote menstruation. Most women with PCOS are surprised to find that their estrogen levels fall within the normal range (about 25-75 pg/ml).