Diagnosing PCOS

There are a number of signs and symptoms women with PCOS can have. However, not every woman with PCOS will have every symptom, and each woman will be quite individual in her experience.

Screening criteria for a diagnosis of PCOS

To enable diagnosis of poly cystic ovary syndrome one must have at least two out of three of the following criteria:

1. There is menstrual dysfunction such as:

  • lack of periods or menses (menstrual flow)
  • menstrual irregularity
  • lack of ovulation (where an egg is released)

2. The ovaries are “poly cystic” because:

  • 12 or more follicles are visible on one ovary or
  • the size of one or both ovaries is increased

3. There are:

  • high levels of ‘male’ hormones (androgens) in the blood (hyper androgenism)
  • symptoms suggesting an excess of androgens such as:
  • excess hair growth
  • acne

With these criteria, a woman can be diagnosed with PCOS even if she has regular periods or normal androgen levels. This means women with PCOS can experience very different types of symptoms.


Below are some of the tests recommended for medical detection of condition. As part of the diagnosis, doctor reviews medical history and assess physical symptoms, weight and BMI (body mass index) to establish the needs of further tests.


An ultrasound of the uterus, ovaries and the pelvis can be carried out to identify whether there are any cysts on ovaries and whether an ovary is enlarged.

Blood tests

Hormonal blood tests

Blood tests are used to assess the levels of androgens in body. Blood tests for androgens (such as testosterone) and free androgen index (FAI) are the best tests for diagnosing whether one may have high androgen levels.

Blood tests may also be done to assess the levels of other reproductive hormones in the body as these may affect menstruation. These may include testing levels of:

  • Oestradiol (oestrogen)
  • Follicle stimulating hormone (FSH)
  • Luteinizing hormone (LH)
  • Androgen hormones

Blood tests to exclude other conditions that have similar symptoms to PCOS may measure the levels of:

  • Thyroid stimulating hormone (TSH)
  • Prolactin
  • Hormones related to adrenal function (glands found above the kidney).

Other blood tests

Other blood tests are also carried out when testing for PCOS because there are links between PCOS and insulin resistance and being overweight. The risk is further analyzed for development of cardiovascular disease and diabetes. Blood tests to assess these risks will measure:

  • Cholesterol
  • Blood pressure
  • Glucose metabolism/ tolerance

If one have PCOS it is recommended to test cholesterol and glucose every two years, and blood pressure should be checked every year. If there are risk factors such as a family history of diabetes or previous abnormal cholesterol tests then these tests should be performed more frequently.

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