PCOS is a complex condition and can show up differently in different women. This makes PCOS diagnosis challenging, as many other conditions can present similarly to PCOS. Because of this, PCOS diagnosis relies on ruling out other possible causes.
Having said that, there is no specific or particular test to determine if you have PCOS or not. If you have symptoms such as irregular periods or sudden excessive growth of hair, your doctor might ask you to take a couple of tests to actually understand if these symptoms are a result of PCOS or not.
In a lot of conditions, the diagnosis is based on recording the symptoms and pointing it towards a particular reason based on confirmatory tests. In the case of PCOS, your doctor eliminates other possibilities before confirming it to be PCOS. Along with a few blood tests, you may have to undergo a pelvic exam or an ultrasound to make sure that the condition you have is PCOS indeed.
- DHEA/Testosterone blood test
Testosterone and dehydroepiandrosterone (DHEA) are androgens or “male hormones” and are responsible for symptoms of PCOS such as acne, excessive growth of hair (hirsutism), and irregular periods. The levels of these androgens are checked, and if they are high for you, it can support the diagnosis for PCOS. Some women may also face the symptoms of acne and hirsutism without the high levels of androgen, and so, this test is only a supporting element and not a confirmatory test for PCOS.
- Pelvic exam or ultrasound imaging
This examination captures the possibility of how your ovaries may look like with the help of an ultrasound device. It will show the doctor if you have any cysts in your ovaries or if the lining of your uterus has thickened abnormally.
- FSH/LH blood test
FSH (follicle stimulating hormone) and LH (luteinising hormone) are hormones that are largely responsible for regulating your ovulation. FSH prompts the growth of the egg follicle and LH is responsible for the release of this egg during the period of ovulation. In most women with PCOS, the levels of FSH are lower than that of LH, and therefore, these levels may support the diagnosis of PCOS. But this test cannot confirm PCOS because it can indicate other possible conditions too.
- Thyroid Stimulating Hormone (TSH) Test: Having hypothyroidism can cause similar symptoms to that of PCOS, especially irregular periods. In order to rule out hypothyroidism as the cause of your symptoms, you maybe required to get a TSH test done. TSH controls the levels of thyroid hormones (T3 and T4) — when the levels of these hormones are low, you can have PCOS-like symptoms.
The process of diagnosing your PCOS may seem exhaustive but the multi-faceted nature of PCOS demands various tests to be sure that the condition you have is indeed – PCOS. It is good to talk about your feelings of this journey with a close one or with your therapist to process it better.