There’s no specific test to definitively diagnose and pinpoint polycystic ovary syndrome. The doctor follows an elimination or exclusion strategy to diagnose PCOS-this means your doctor will thoroughly examine you first to rule out causes other than PCOS that could possibly lead to occurrence of the symptoms. During this process, your doctor will ask you specifics to understand your medical history, including your menstrual periods, weight changes and other symptoms. Your doctor may also recommend certain tests and procedures.
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 indicative of excess androgen secretion manifest as.
- Hirsutism or excess facial or body hair growth
- Hair loss on the scalp-typical of male pattern baldness
- acne – uncontrolled acne
Menstrual Dysfunction with following symptoms
- Missing periods
- menstrual irregularity or irregular/delayed periods
- lack of ovulation (cessation of egg release)
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 examine your reproductive organs to observe for any abnormal structures or growths.
Your doctor may order the following blood tests to diagnose various complications that are associated with PCOS
- Testosterone: High levels of this male hormone can hinder ovulation, cause baldness and develop other masculine features
- Prolactin, which plays a role in controlling menstrual cycle
- Cholesterol and triglycerides, which can co-exist at high 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.
- Glucose tolerance and insulin levels, which are predictive of insulin resistance and likelihood of developing diabetes
- Diabetes: If you have PCOS, your doctor will calculate your chances of developing diabetes based on your family history, lifestyle, and presence of any other chronic disorders. Later, a thorough judgment will be made based on regular blood tests to check for any red flags.
- Heart disease: Regular checking of cholesterol levels, blood pressure, and evaluating these values with reference to each other to rule out possibilities of any cardiovascular risks.
An ultrasound is an imaging technique that scans your ovaries and produces clear images of the same on the screen, which can enable the doctor to see for presence of any abnormalities or unusual appearances. This test is useful in diagnosing PCOS, by showing the appearance of ovaries and thickness of lining of the uterus. An ultrasound of the uterus, ovaries and the pelvis can be carried out to identify the presence of any ovarian cysts or enlargements.
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 which hit the object of reference and produce an image of the object on the screen. Alternatively, a pelvic transabdominal ultrasound may also be performed by a doctor. This is done by producing images of the lower abdomen. It’s only performed in women who have been sexually active, otherwise in other cases, an abdominal scan is sufficient.