There’s no specific test to definitively diagnose polycystic ovary syndrome. The diagnosis is one of exclusion, which means your doctor considers all of your signs and symptoms and then rules out other possible disorders.
During this process, you and your doctor will discuss your medical history, including your menstrual periods, weight changes and other symptoms. Your doctor may also perform certain tests and exams.
Criteria for a diagnosis of PCOS
A diagnosis of polycystic ovary syndrome can be made when at least two out of three of the following criteria are met:
The ovaries are ‘polycystic’:
- 12 or more follicles are visible on one ovary, or
- the size of one or both ovaries is increased
High levels of ‘male’ hormones (androgens, testosterone) in the blood (hyperandrogenism): Symptoms suggesting an excess of androgens such as:
- Hirsutism or excess facial or body hair growth
- scalp hair loss or balding
- acne – uncontrolled acne
Menstrual Dysfunction with following symptoms
- lack of periods where PCOS patients do not have any menstrual flow
- menstrual irregularity or irregular periods
- lack of ovulation (where an egg is released)
Polycystic Ovarian Syndrome Diagnosis
Below are some of the tests that your doctor will perform or order to diagnose PCOS
During your physical exam, your doctor will note several key pieces of information, including your height, weight and blood pressure
During a pelvic exam, your doctor visually and manually inspects your reproductive organs for signs of masses, growths or other abnormalities
Your doctor may order the following blood tests to diagnose various complications that are associated with PCOS
- Testosterone: Androgens (male hormone) at high levels can block ovulation and cause 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.
- 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.
- Glucose tolerance and insulin levels, which can show insulin resistance.
- Diabetes: If you have PCOS, experts recommend that you have blood glucose testing for diabetes by age 30.3 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.
An ultrasound exam can show the appearance of your ovaries and the thickness of the lining of your uterus. An ultrasound of the uterus, ovaries and the pelvis can be carried out to identify whether there are any cysts on your ovaries and whether an ovary is enlarged.
During the test, you lie on a bed or examining table while a wand-like device (transducer) is placed in your vagina (transvaginal ultrasound). The transducer emits inaudible sound waves that are translated into images on a computer screen. Alternatively, a pelvic transabdominal ultrasound may also be performed by a doctor. This is done by moving the transducer across the lower abdomen. Some pressure may be applied to get a good image. Transvaginal ultrasounds are only performed on women who have been sexually active, otherwise an abdominal scan is done where the ovaries are viewed from the outside through the stomach wall.
PCOS Diagnosis and Treatment
Being Diagnosed with PCOS may be a harrowing experience for women. But with right changes in lifestyle and medication, women with PCOS can control their complications associated with PCOS.
PCOS treatment focuses on each of your symptom and hence PCOS treatment is different from person to person. Lifestyle modifications become as important as medication in case of PCOS Management.
If you are battling with infertility related to PCOS, your doctor will recommend weight loss to increase the effectiveness of the medication.
A low calorie diet coupled with moderate exercise has known to greatly improve the symptoms related to PCOS. Doctors typically recommending losing 5% of your body weight to begin with.