PCOS Diagnosis

Physical exam | Medical history | Laboratory tests | Imaging studies

Polycystic ovary syndrome (PCOS) is diagnosed when women have abnormal menstrual periods and infertility problems and seek medical attention for it. Your doctor will make a diagnosis of PCOS depending on your symptoms and signs. Physical exam, blood tests, imaging studies and procedures are carried out for confirmation that you are having PCOS. Family and personal medical history will be checked for risk factors.

Physical exam

Your doctor or nurse will conduct a physical examination. He/she will take height-weight ratio for body mass index (BMI) and upper body obesity. He will check for excess hair growth both on face and all over the body and for hair loss and thinning of scalp hair. He will check for acne, and other skin problems. He will do a pelvic exam to check for swollen ovaries. He will also check for high blood pressure and order extensive laboratory tests.

Medical history

The doctor will ask about your menstrual cycles, like how many periods a year you get, about the bleeding pattern and whether you have pelvic pain. He will ask details about previous pregnancies, miscarriages. He will check for family history of PCOS on both the paternal and maternal side of the family. He will check for earlier than usual balding pattern in male members of the family. He will ask about feeling depressed or mood swings.

Laboratory tests

Blood tests will be needed for checking hormone levels like

• Estrogen level.
• Androgen (testosterone) level.
• Follicle stimulating hormone (FSH) level.
• Luteinizing Hormone (LH) level.
• Androstenidione level.
• Free testosterone level
• 17 OH progesterone level.
• Fasting glucose level.
• Tests for glucose intolerance and insulin resistance.
• Lipid levels.
• Serum HCG level for pregnancy.
• Thyroid function tests.
• Prolactin level.

Imaging studies

• Vaginal ultrasound – for looking at cysts in the ovaries and check the thickness of lining of the womb which is thicker with irregular periods.
• Pelvic laparoscopy (optional).

Other medical conditions with similar features are raised levels of prolactin and of thyroid stimulating hormone (TSH) which can cause abnormal menstrual periods. These will be ruled out with laboratory studies.

Prognosis

PCOS treatment can start with weight control, correcting hormone levels and prevention of long-term complications like diabetes, cardiac issues as well for treating infertility. With the right treatment plan and strict adherence to life-style changes, women afflicted with PCOS can overcome all symptoms, can get pregnant if desired and lead a normal life.

• References

• • University of Maryland – Medical Center – Polycystic Ovary Syndrome – Overview view
  • National Institute of Health – Pubmed view
  • NetDoctor – PCOS view
  • Mayo Clinic – PCOS view