How is PCOS diagnosed?

There isn’t a single test to determine if a woman has polycystic ovary syndrome (PCOS). So how is the condition diagnosed?

To diagnose PCOS, doctors look for certain telltale symptoms of PCOS. Once he or she has ruled out any other possibilities that could be at play, the provider will make a diagnosis. How doctors test for PCOS varies among providers and specific circumstances, but for the most part, there are a couple of things that usually happen before a woman is diagnosed with the condition.

  • Medical history: Family history is the most significant risk factor for PCOS, so a provider will normally ask if the patient has any relatives with PCOS, as well as the patient’s own medical history.
  • Physical exam: Doctors check the patient’s weight and height, blood pressure, and waist measurements. They might also check to see if there is abnormal facial or body hair and/or acne, which are common symptoms of PCOS.
  • Pelvic exam: A pelvic exam can help providers see if there are any abnormalities in the patient’s reproductive organs. Women with PCOS often have swollen ovaries because of cysts that are present within one or both ovaries. 
  • Blood tests: Blood testing is helpful for a number of reasons when it comes to PCOS. Providers can use blood to check specific hormone and glucose levels in the patient’s blood. If either are elevated, a diagnosis of PCOS is more likely.
  • Transvaginal ultrasound: A transvaginal ultrasound is performed both to look at a woman’s ovaries and to see the thickness of her uterine lining. Multiple cysts within one or both ovaries can support a diagnosis of PCOS, and a thicker-than-normal lining of the uterus can be suggestive of an absence of menstruation, which supports a PCOS diagnosis. 

Clinical guidelines from the Journal of Clinical Endocrinology and Metabolism suggest that providers use the ‘Rotterdam criteria’ to diagnose PCOS. This means they should look for two out of the following three criteria to diagnose PCOS: high levels of androgen hormones, lack of ovulation or disrupted ovulation, and polycystic ovaries.

A PCOS diagnosis may seem intimidating to women who are wondering if they have the condition. But because PCOS can go undiagnosed for so long, and because it can have negative effects if left untreated, every diagnosis of PCOS is an accomplishment and a step towards a healthier life.

  • “PCOS Diagnosis.” PCOSAA. PCOS Awareness Association, 2016. Web.
  • “Polycystic ovary syndrome (PCOS) fact sheet.” WomensHealth. Office on Women’s Health, US Department of Health and Human Services, Dec 23 2014. Web.
  • Jaime Herndon. “Polycystic Ovary Syndrome.” Healthline. Healthline Media, 2016. Web.
  • Mayo Clinic Staff. “Polycystic Ovary Syndrome (PCOS): Tests and diagnosis.” MayoClinic. Mayo Foundation for Medical Education and Research, Sep 3 2014. Web.
  • Michael Sheehan. “Polycystic Ovarian Syndrome: Diagnosis and Management.” Clinical Medicine & Research. 2(1): 13–27. Web. Feb 2004.
  • Richard S. Legro, Silva A. Arslanian, David A. Ehrmann, Kathleen M. Hoeger, M. Hassan Murad, Renato Pasquali, Corrine K. Welt. “Diagnosis and Treatment of Polycystic Ovary Syndrome: An Endocrine Society Clinical Practice Guideline.” Clinical Guidelines. Journal of Clinical Endocrinology & Metabolism. Jc.2013–2350. Web. Dec 2013.
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