Diagnosing PCOS

As you might know, many doctors use different methods to diagnose PCOS. Though it is impossible to predict the tests your doctor will suggest you to have, as a general rule of thumb the following tests will be performed. I had provided information based on the tests my doctor asked me to do. It is by no means the complete list.

Ultrasound:

The first and foremost test that you might need to perform is a ultrasound scan. If you are diagonised with a PCO it is important not to assume that you have PCOS. As per statistics, around 25% of women have PCO yet only 5-10% of them PCOS.

Others blood tests suggested by my doctor:

HARMONES(Serum) :

SHBG
FAI
FSH
LH
Progesterone
Prolactin
Oest-17 Beta
Testosterone

Tests in Conjuctions:

BIOCHEMISTRY:

Leptin
Insulin
Glucose

Note that all the above are after 12 hrs fasting. Glucose and Insulin levels are taken after consuming a sugar concentrated juice in addition to fasting levels.

LIPID STUDIES:

Cholesterol
Triglycerides
HDL-Chol
LDL-Chol

CHOLESTEROL RATIOS:

LDL/HDL
Chol/HDL

VITAMINS :

Vitamin D

Below is the normal reference range for all the above tests. Please note that reference range might sometimes vary depending on which country you reside in.

HARMONES - Reference Ranges :

1. Prolactin 2.8-29.2 ng/L

2. Testosterone 0.7-2.8 nmol/L

3. FSH - 1.0-6.0(Follicular), 6.0-12.0(Midcycle), 1.0-6.0(Luteal), >20.0(Menopausal)

4. LH - 3.0-10.0(Follicular), 20.0-40.0(Midcycle), 3.0-10.0(Luteal), >35.0 (Menopausal)

5. Progesterone - 0.6-2.6(Follicular), NA,13.0-75.0(Luteal), <2.0 (Menopausal)

6. Oestradiol - 100-630(Follicular), 550-1650(Midcycle), 200-900(Luteal), 40-300 (Menopausal)

7. SHBG(Female Range-nmol/L ) - 24-230(Follicular), 48-185(Luteal), 89-379(Contraceptives), 46-277 (PostMenopausal )

8. SHBG (Pregnant Range-nmol/L) - 59-1162(First Trimester), 324-956(Second Trimester), 312-1363 (Third Trimester)

VITAMINS

1. Vitamin D - 48-144

LIPID STUDIES –Fasting

1. Cholesterol - 3.0-5.5 mmol/L

2. Triglycerides - 0.6-2.0 mmol/L

3. LDL - 0.8-2.0 mmol/L

4. HDL - 1.6-3.0 mmol/L

LP- RATIOS

1. LDL/HDL - <3.0

2. Chol/HDL - <4.0

BIOCHEMISTRY

1. Glucose -3.0-5.5.mmol/L (Fasting)

2. Insulin -0-20 mIU/L (Fasting)

3. Leptin - 3.7-11.1 ng/mL

Not many you might be aware that PCOS women are deficient in Calcium and Vitamin D. So, most doctors nowadays recommend Vitamin D test to figure out your levels. If you plan to get pregnant, it is better to test your Vitamin D levels so that you can start taking supplements.

Leptin is another hormone that might be linked to PCOS. My naturopath recommended me to test my leptin levels as I am thin cyster and she suspected that I might have been anorexic in the past( which I am not). Surprisingly, my Insulin levels are very good and I had slightly high leptin levels. So, that might be the contributing factor to my PCOS. Unfortunately, there is not much study done to establish the link between PCOS and leptin.

Based on your hormone tests, generally doctors conclude that you have PCOS, if you have 2 of the following symptoms:

1. Anovulation - Irregular or absent periods

2. PCO - Polycystic Ovary in ultrasound

3. Elevated Androgen Levels( basically testosterone level)

If you had any other tests to diagnose PCOS, feel free to post it here.