Understanding PCOS: Diagnosis and tests you need

Polycystic Ovary Syndrome (PCOS) can feel confusing and overwhelming. If you're wondering whether you might have PCOS, it’s important to know what tests are needed for a diagnosis and what the criteria are. Here’s a quick and easy guide to what the diagnosis of PCOS involves and what you can expect.

How is PCOS diagnosed? 

PCOS isn’t diagnosed by just one test. Instead, doctors use a combination of criteria to make a diagnosis. You need to meet at least two out of three specific conditions to be diagnosed with PCOS: 

1. Irregular or absent periods: This includes irregular menstrual cycles that are longer than 35 days, fewer than 6-8 periods a year, or amenorrhoea (when periods stop altogether, or are absent for 3-4 consecutive cycles). These symptoms indicate that your ovaries do not regularly release eggs (ovulate). 
2. Excess androgen levels: Androgens are often called "male hormones," but women have them too. Symptoms of high androgen levels include excessive hair growth (hirsutism), acne, and alopecia (similar to male-pattern baldness). Blood tests can measure your androgen levels to confirm this condition. 

3. Polycystic ovaries: This means that your ovaries are larger than normal or have many small follicles (often misinterpreted as cysts). An ultrasound can help identify polycystic ovaries. 

Meeting two of these three criteria confirms a PCOS diagnosis. Here’s a closer look at the tests and evaluations involved: 

Tests for diagnosing PCOS 

Medical history and physical exam 

• Your doctor will ask about your menstrual cycle, weight changes, and other symptoms. 

• A physical exam will check for signs of excess hair growth, acne, and other symptoms. 

Blood tests 

• Hormone levels: These tests measure levels of androgens, such as testosterone. Other hormones, like LH (luteinising hormone), FSH (follicle-stimulating hormone), and prolactin, might also be checked. 

• Blood sugar and cholesterol: Women with PCOS are at higher risk for insulin resistance, type 2 diabetes, and high cholesterol. The HbA1c test can measure your average blood sugar levels over the past three months. 

• Thyroid function: Since thyroid issues can mimic or exacerbate PCOS symptoms, tests for thyroid function, including TSH (thyroid-stimulating hormone), are often conducted. 

Pelvic ultrasound 

• An ultrasound uses sound waves to create images of your ovaries and check for the presence of follicles. The doctor will look for 12 or more follicles in each ovary or increased ovarian volume. 

Why diagnosing PCOS is important 

Getting an accurate diagnosis is important for managing PCOS effectively. Knowing you have PCOS allows you to: 

Manage symptoms: Treatment can help regulate your menstrual cycle, reduce hair growth, clear up acne, and help with weight management. 

Reduce health risks: PCOS is linked to other health issues like diabetes, high blood pressure, and sleep apnoea. Early diagnosis can help you take steps to prevent these problems. 

Prevent serious health issues: If you have fewer than 4 periods a year or your periods have stopped altogether, you may be at increased risk of endometrial cancer. Medications can help trigger a period and reduce this risk. 

Plan for pregnancy: If you’re trying to conceive, understanding your PCOS can help you and your doctor develop a fertility plan tailored to your needs. 

PCOS and IVF

For women with PCOS who are struggling to conceive, In Vitro Fertilisation (IVF) can be a highly effective fertility treatment. PCOS often causes irregular ovulation or anovulation (lack of ovulation), making it difficult to achieve pregnancy naturally.  

IVF bypasses this issue by allowing the eggs to be retrieved and fertilised outside the body, before being implanted into the uterus. Additionally, IVF offers the possibility of better controlling and monitoring the ovarian response, which is crucial for women with PCOS who may be at risk of ovarian hyperstimulation syndrome (OHSS). Read more about ovarian stimulation regimes here.

If you're dealing with PCOS and facing challenges with fertility, IVF can be a promising step towards achieving your dream of parenthood. 

When to seek help 

If you've been trying to conceive for a year or more without success, it may be time to consult a fertility specialist. At Care Fertility, we offer comprehensive evaluations and customised plans to support you on your journey. We know that managing PCOS while trying to conceive can be challenging, and we're here to provide the care and expertise you need. 

Next steps: Speak to your GP or a fertility specialist 

If you suspect you have PCOS or have been trying to conceive without success, your first step should be gathering information about your condition. Consult your GP or a fertility specialist, providing details about your menstrual cycle, any PCOS symptoms, and how long you've been trying to conceive. This information is crucial in creating an effective treatment plan. For more guidance on how to start, including navigating the NHS referral process, read our guide.  

We’re here for you 

We know that dealing with PCOS can be overwhelming, but you don’t have to go through it alone. At Care Fertility, we’re here to guide you through the process, providing the tests you need and the support you deserve on your fertility journey. Reach out to us today – we’re here to make sure you feel seen, heard, and supported every step of the way. 

Real stories, real hope

Hearing from others who have faced similar challenges can be comforting. Read Stephanie’s story, where she shares her experience with PCOS and IVF at Care Fertility. Her journey highlights the importance of seeking help early and how personalised care can make a significant difference.