There is no single diagnostic test for PCOS. It is important to ensure the patient is not taking the OCP before hormone testing. Key investigations include testosterone, SHBG, free androgen index, prolactin and TSH. Optional investigations include a pelvic ultrasound for ovarian morphology and endometrial thickness.

An OGTT and lipid profiles are appropriate in all women at diagnosis. If results are normal, they should be rescreened approximately every two years. If results show that a patient has impaired glucose tolerance (IGT), she should be screened annually for diabetes. IGT should be treated intensively with lifestyle modifications and meformin should be considered.⁹ A fasting glucose level does not suffice in excluding either IGT or diabetes in these women, as noted previously. Insulin levels are not recommended in clinical practice because of assay variability and inaccuracy. Metabolic syndrome and abnormal glucose metabolism best reflect insulin resistance in this population.

This article first appeared in Australian Doctor, How to treat on 29 August 2008 and has been reproduced here with permission.

 Australian Doctor, How to treat: Polycystic ovary syndrome 437.44 Kb

Content Updated 20 November, 2009