What blood tests should be done to diagnose PCOS?
Much of the blood work that should be done in diagnosing or ruling out PCOS is the same as a basic fertility workup; however, there are a couple of additional tests for insulin resistance that should be added, as well as some cholesterol screening to evaluate general health status because of the future risks associated with PCOS.
It is not clear what comes first, insulin resistance or PCOS, but we do know they are related. PCOS is also related to metabolic syndrome: high blood pressure, diabetes and increased risk of heart attacks and strokes.
There are hormonal abnormalities in PCOS where there are more androgens (male-like hormones) than estrogens (female hormones). Patients come in complaining of cystic acne, excess hair growth, hair loss, abnormal or irregular periods, difficulties conceiving.
When I suspect a diagnosis of PCOS, the tests that I send for are:
1. ones related to diabetes and hypercholesterolemia:
- complete blood count
- comprehensive metabolic panel
- lipid panel
- hemoglobin A1C, which shows the average blood sugar levels over the last three months.
- 3 hour glucose tolerance test
2. hormone tests:
- FSH (follicle stimulating hormone)
- LH (leuteinizing hormone)
- DHEA-S
- Androstienedione
- Total testosterone
- Free testosterone
- Sex hormone binding globulin
- 17-OH progesterone
- Prolactin
Much of the bloodwork that should be done in diagnosing or ruling out PCOS is the same as a basic fertility workup; however, there are a couple of additional tests for insulin resistance that should be added, as well as some cholesterol screening to evaluate general health status because of the future risks associated with PCOS.
Much of the bloodwork that should be done in diagnosing or ruling out PCOS is the same as a basic fertility workup; however, there are a couple of additional tests for insulin resistance that should be added, as well as some cholesterol screening to evaluate general health status because of the future risks associated with PCOS. A good basic screening would include: Fasting comprehensive biochemical and lipid panel; 2-hour GTT with insulin levels (also called IGTT); LH:FSH ratio; Total testosterone; DHEAS; SHBG; Androstenedione; Prolactin and TSH If you click on this link, you will get more info including normal lab ranges for the blood tests listed above: http://www.inciid.org/faq/pcos2.html#2.
