A PCOS diagnosis is just the starting point. The real question is: what’s happening inside your particular case of PCOS? Because PCOS isn’t one condition – it’s a syndrome with different patterns in different women. Knowing your specific hormonal profile guides your treatment.
Here is the complete list of tests I recommend for any woman newly diagnosed with PCOS, along with what we’re looking for with each one.
Blood Tests
Day 2–3 Hormone Panel
- FSH (Follicle-Stimulating Hormone): Assesses ovarian reserve and rules out other causes of irregular periods
- LH (Luteinising Hormone): Elevated LH:FSH ratio (above 2:1) is a classic PCOS pattern
- Oestradiol: Baseline oestrogen level
- AMH (Anti-Müllerian Hormone): Often very high in PCOS; also reflects ovarian follicle activity
- Testosterone (total and free): Androgen excess is present in 60-80% of PCOS
- DHEA-S: Adrenal androgen; elevated in adrenal PCOS variant
Metabolic Tests
- Fasting glucose and insulin: To detect insulin resistance
- 2-hour glucose tolerance test: More sensitive than fasting glucose for detecting pre-diabetes in PCOS
- HbA1c: 3-month average blood sugar
- Fasting lipids (cholesterol panel): PCOS increases cardiovascular risk; early lipid monitoring is important
Thyroid and Prolactin
- TSH: Thyroid disease mimics and worsens PCOS; must be ruled out
- Prolactin: Elevated prolactin suppresses ovulation and can coexist with PCOS
Imaging
- Pelvic ultrasound (transvaginal or transabdominal): Looking for polycystic ovary morphology (12+ follicles per ovary, increased ovarian volume), uterine abnormalities, and endometrial thickness
Additional Tests If Needed
- 17-OH Progesterone: To rule out congenital adrenal hyperplasia (CAH), a condition that mimics PCOS
- Bone density (DEXA): For women with long-standing absent periods or low oestrogen
- Liver function tests: If starting metformin
This may seem like a lot, but each test helps us understand your PCOS and design the right treatment. Not everyone needs every test – we’ll pick the most relevant ones based on your specific symptoms and history.
Book your PCOS evaluation at Sadhbhavna Clinics Chandigarh and get a comprehensive, personalised approach to managing your condition.