PCOS Lab Panel: The Tests You Need for Diagnosis

Polycystic Ovary Syndrome (PCOS) affects up to 10% of women of reproductive age, yet many go undiagnosed for years. The right lab tests can provide crucial insights for diagnosis and management.

What Is PCOS?

PCOS is a hormonal disorder characterized by:

• Irregular or absent periods
• Excess androgen (male hormone) levels
• Polycystic ovaries on ultrasound

You don't need all three criteria for diagnosis - two of the three is typically sufficient.

Essential PCOS Labs

Androgen Panel

• Total Testosterone: Often elevated in PCOS
• Free Testosterone: The active form, more sensitive for detecting excess
• DHEA-S: Adrenal androgen that may be elevated

Reproductive Hormones

• LH and FSH: LH/FSH ratio >2:1 is common in PCOS
• Estradiol: May be normal or elevated
• Progesterone: Often low due to anovulation
• AMH: Often elevated in PCOS

Metabolic Tests

• Fasting Insulin: Insulin resistance is common in PCOS
• Fasting Glucose and HbA1c: Screen for prediabetes/diabetes
• Lipid Panel: PCOS increases cardiovascular risk

Thyroid Panel

Thyroid dysfunction can mimic PCOS symptoms and should be ruled out.

Understanding Your Results

PCOS is a syndrome, meaning it presents differently in everyone. Your lab results help identify which type of PCOS you have and guide treatment.

References

• Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. (2004). Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertility and Sterility, 81(1), 19-25.
• Azziz, R., et al. (2004). The prevalence and features of the polycystic ovary syndrome in an unselected population. Journal of Clinical Endocrinology & Metabolism, 89(6), 2745-2749.
• Legro, R. S., et al. (2013). Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology & Metabolism, 98(12), 4565-4592.