Polycystic Ovary Syndrome (PCOS) - Exams and Tests

Exams and Tests

If you have possible symptoms of polycystic ovary syndrome (PCOS), such as menstrual cycle problems or trouble getting pregnant, see your doctor for an exam. PCOS increases your risks of infertility, metabolic syndrome, uterine cancer, diabetes, and heart disease. If you are diagnosed with PCOS, be sure to have regular checkups. This helps you and your doctor lower your risk of these serious health problems.

No single test can show that you have PCOS. Your doctor will talk to you about your medical history, do a physical exam, and run some lab tests. You may also have an ultrasound scan of your pelvis.

• The medical history includes questions about your menstrual cycles and your lifestyle, including what you eat, changes in your weight, how you get exercise, and how stress affects you. Be sure to mention whether you have lost hair from your scalp or have male-pattern facial or body hair. You will also talk about any family history of hormone (endocrine) problems, including diabetes.
• The physical exam checks your thyroid, skin, hair, breasts, and belly. You will have a blood pressure check and a pelvic exam to check for enlarged or abnormal ovaries. Your doctor can also tell you what your body mass index (BMI) is, which is based on your height and weight.

Lab tests are also used to look for signs of PCOS, such as high insulin and blood sugar (glucose) levels, high androgen levels, and unhealthy cholesterol levels. These tests can include checking your blood for:

• Human chorionic gonadotropin (hCG), to learn whether you are pregnant.
• Testosterone, a "male" hormone. A high level of this androgen blocks ovulation. It also causes acne, male-type hair growth on the face and body, and hair loss from the scalp.
• Prolactin, which can play a part in a lack of menstrual cycles or infertility.
• Cholesterol and triglycerides, which can be at unhealthy levels with PCOS.
• A chemistry screen to check kidney and liver function and glucose levels.
• Thyroid-stimulating hormone (TSH) to check for an overactive or underactive thyroid.
• Adrenal gland hormones, such as DHEA-S or 17-hydroxyprogesterone. An adrenal problem can cause symptoms much like PCOS.
• Oral glucose tolerance test, which measures your body's ability to use insulin. Insulin lets sugar (glucose) enter your body's cells, where it is used for energy. If your body is not using insulin well (insulin resistance), your insulin and blood sugar levels both rise. This is sometimes called prediabetes.

A pelvic ultrasound can show enlarged ovaries or more eggs than normal on the ovaries, which are signs of PCOS. But many women with PCOS do not have these signs.

Regular testing for diabetes, heart disease, and uterine cancer for women who have PCOS

Diabetes. If you have PCOS, experts recommend that you have blood glucose testing for diabetes by age 30.⁹ You may have this done at a younger age if you have PCOS and other risk factors for diabetes (such as obesity, lack of exercise, a family history of diabetes, or gestational diabetes during a past pregnancy). After this, your doctor will tell you how often to have testing for diabetes.

Heart disease. Your doctor will regularly check your cholesterol and triglycerides, blood pressure, and weight. This is because PCOS is linked to higher risks of high blood pressure, weight gain, high cholesterol, heart disease, hardening of the arteries (atherosclerosis), heart attack, and stroke.

Uterine (endometrial) cancer. Regular menstrual cycles normally build up and "clear off" the uterine lining every month. When the uterine lining builds up for a long time, precancer of the uterine lining (endometrial hyperplasia) can grow. If you have had infrequent menstrual periods for at least 1 year, your doctor may use a transvaginal ultrasound and/or endometrial biopsy to look for signs of precancer or cancer.³