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Tests

There is no specific test that can be used to diagnose polycystic ovary syndrome (PCOS) and there is no widespread agreement on what the diagnostic criteria should be. A health practitioner will typically evaluate a combination of clinical findings such as a woman's signs and symptoms, medical and family history, and physical exam as well as laboratory test results to help make a diagnosis.

Some testing may done to rule out other possible causes of PCOS-like symptoms before a PCOS diagnosis can be made. For example, adrenal or ovarian tumors or an overgrowth in adrenal tissue called adrenal hyperplasia can also cause an overproduction of male hormones in women.

Laboratory tests

  • FSH (follicle stimulating hormone), will be normal or low with PCOS
  • LH (luteinising hormone), will be elevated
  • Testosterone, total and/or free, usually elevated
  • Dehyrdoandroepiandrosterone sulphate (DHEAS) (may be done to rule out a virilising adrenal tumour in women with rapidly advancing hirsutism), frequently mildly elevated with PCOS
  • Oestradiol, may be normal or elevated
  • Sex hormone binding globulin (SHBG), may be reduced
  • Androstenedione, may be elevated
  • hCG (human chorionic gonadotropin), used to check for pregnancy, negative
  • Lipid profile (low HDL, high LDL and total cholesterol, elevated triglycerides)
  • Glucose, fasting and/or a glucose tolerance test, may be elevated
  • HbA1c to check for diabetes, may be elevated
  • TSH (thyroid stimulating hormone) to rule out hypothyroidism
  • AMH (anti mullerian hormone) is currently under investigation to help diagnose PCOS

Non-laboratory tests

Ultrasound, transvaginal and/or pelvic/abdominal are used to evaluate enlarged ovaries. With PCOS, the ovaries may be 1.5 to 3 times larger than normal and characteristically have more than 12 follicles per ovary, with each follicle less than 10 mm in diameter. Often the cysts are lined up on the surface of the ovaries, forming the appearance of a "pearl necklace." These ultrasound findings are not diagnostic.

Laparoscopy may be used to evaluate ovaries, evaluate the endometrial lining of the uterus, and sometimes used as part of surgical treatment.


Last Review Date: July 1, 2018