There are a number of symptoms that women with PCOS can have (see Symptoms). However, not every woman with PCOS will have every symptom and each woman will be quite individual in her presentation.  

A diagnosis of polycystic ovary syndrome is made when at least two out of three of the following criteria are met:

• Polycystic ovaries are present on the ultrasound
• High levels of male hormones are in the blood (hyperandrogenism), or symptoms suggesting an excess of male hormones are present (e.g. excessive hair growth, acne etc.)
• Menstrual dysfunction (e.g. lack of menses (menstrual flow), menstrual irregularity or lack of ovulation)

To make sure the diagnosis of PCOS is correct, a number of other conditions that could cause similar symptoms of menstrual dysfunction have to be excluded.

Testing for PCOS

Below are some of the tests your health practitioner may recommend in testing for PCOS and excluding other conditions. Please note: not all tests are necessary in every woman.

Tests may include:

Clinical features

• A thorough medical history and examination, including weight and BMI.

Ultrasound

• A transvaginal ultrasound of the uterus, ovaries and the pelvis. A transvaginal ultrasound is a painless test with no radiation. It uses a pen-shaped probe with an ultrasound sensor on the tip which is inserted into the vagina (this produces a much clearer picture than an abdominal ultrasound). Transvaginal ultrasounds are only performed on women who have been sexually active in the past, otherwise an abdominal scan is done (viewing the ovaries through the tummy wall).

Blood tests

• Hormonal blood tests such as: 
  - Blood tests for androgens (testosterone, DHEAS, androstenedione), sex hormone binding globulin (SHBG) and free androgen index (FAI).
  - Blood tests for other reproductive hormones e.g. oestradiol, follicular stimulating hormone (FSH) and Luteinizing Hormone (LH).
• Blood tests for thyroid TSH and prolactin levels which can mimic PCOS symptoms
• Blood tests for cholesterol, and blood tests for glucose metabolism (glucose tolerance tests) are important in PCOS and especially in overweight women. Women with PCOS should be screened with a two hour oral glucose tolerance test at diagnosis. If results are normal, they should be rescreened every two years. If results show that a woman has impaired glucose tolerance, she should be screened annually for diabetes. Impaired glucose tolerance should be treated intensively with lifestyle modifications and meformin should be considered.

Other tests

• Other conditions of the adrenal glands, ovaries or pituitary gland will also be ruled out by other tests if necessary.

Content updated July 31, 2009