How Is PCOS Diagnosed: 5 Amazing Ways

Polycystic Ovary Syndrome¹ is a common condition for females today. It is a hormonal disorder that occurs when the hormone levels are altered in females in their reproductive age. There are many problems that women with PCOS face. One of the very common problems is irregular periods or no periods for more than a month or two.

In some females, excess hair growth is visible because of the high levels of androgens. In these type of cases, the ovaries of the females produce many follicles, and as a result, it fails to produce eggs regularly. The main cause of PCOS is still unknown, but let us find out how is PCOS diagnosed.

1. About PCOS

PCOS is now found in most women worldwide. Though the main cause of PCOS is still undiscovered, doctors and researchers think that insulin resistance is one of the key factors of polycystic ovary syndrome.

When polycystic ovary syndrome is compared with the general population, it is seen that metabolic syndrome is also very common in women with PCOS. It is also said that women with PCOS have higher chances of getting affected by type 2 diabetes² mellitus than other people.

2. How Is PCOS Diagnosed

There are two types of patients who are diagnosed with PCOS. One of the types has no symptoms, whereas the other shows various PCOS symptoms like hair excess hair growth and irregular menstrual periods. Not only physically, but women with PCOS also have some common emotional and dermatological problems.

Many guidelines suggest using the Rotterdam Criteria to diagnose PCOS, including the presence of two: polycystic ovaries, ovulatory dysfunction, and hyperandrogenism. For women with PCOS who have crossed their reproductive age, it is suggested that all three Rotterdam Criteria must be met before the doctors diagnose PCOS.

For patients with severe symptoms, it is suggested that they get their diagnosis as soon as possible. It is said so because showing excessive PCOS symptoms can be due to the formation of any androgen-secreting tumour.

The treatment of PCOS is completely dependent from person to person. A treatment of polycystic ovaries that suits one person is not necessary to suit every patient with this disorder. With time the doctors and the patients together find out the best treatment that suits true to the cause.

• Every woman with PCOS should be tested for metabolic abnormalities like dyslipidemia, hypertension, and type 2 diabetes mellitus, irrespective of the body mass index.

• Women with PCOS should also be tested for other problems like hyperprolactinemia, thyroid, and nonclassical congenital adrenal hyperplasia

  ³

  .

• All patients should follow a calorie-restricted diet if they are a victim of weight gain. It has been seen that weight loss has a significant effect on metabolic profile and fertility.

• In many cases, hormonal contraception and oral contraceptives, commonly known as birth control pills, are used as initial treatment for polycystic ovary syndrome. It is used when women with PCOS suffer from irregular menstrual cycles, acne, and other problems. It is important to note that contraceptives are given to women who are not planning to get pregnant shortly.

3. Symptoms Of PCOS

PCOS diagnosis can be tricky sometimes because it is a complex situation, and the symptoms may vary from person to person. Many people show symptoms, whereas others have very few to no symptoms.

The symptoms of PCOS can also change at various stages of life. Generally, three main areas are affected by PCOS, which are mentioned below.

• psychological health

• fertility and reproductive health

• metabolic health

The other problems in this category are irregular periods, the formation of polycystic ovaries, and increased androgen levels.

4. Criteria To Diagnose PCOS

As mentioned earlier, diagnosing PCOS might be tricky at times. The following factors are looked for during the identification of polycystic ovary syndrome.

4.1. Irregular Periods Or No Periods

Having irregular periods or no periods for more than a month or two can be the primary identification factor of PCOS. Due to the change in the levels of the reproductive hormones, and the increase of androgen in the body, women tend to get irregular periods.

Due to irregular ovulation, many women have less than 9 months of yearly periods. In some cases, it also affects women’s overall health with PCOS.

4.2. Higher Level Of Androgen

Women with higher levels of androgen tend to develop many other problems along with excess facial hair growth. Acne and hair fall are some of the other problems they face.

People also often complain about getting bald patches all over their heads because of the excess hair loss. The hair from the scalp starts to reduce, whereas the body hair starts to increase.

Due to the hormonal imbalance in the childbearing age, women with PCOS also face acute acne problems. Though these changes are sometimes hard to address, they can be cured with some lifestyle changes.

A blood test generally measures the level of androgen excess in the body. Various other blood tests are also conducted to get a proper understanding of the androgen excess and the effects it can cause.

Increased androgen levels can cause many other problems apart from the ones mentioned above.

4.3. Formation Of Polycystic Ovaries

The formation of polycystic ovaries is also a common criterion for diagnosing PCOS. More than 20 partly developed eggs are seen on one or both ovaries in this health problem. This condition can also take place is the ovaries get enlarged in size. Similar symptoms are experienced by women in this condition as well.

Women will have to go through an ultrasound to identify this condition. However, girls under 20 years old may not undergo ultrasound for this condition.

Apart from the problems mentioned above, many other conditions can cause similar symptoms of irregular periods or no periods for more than a month or two. It is advised to consult your doctor at the earliest if you are facing any of these problems.

5. When To Go to A Doctor?

It is best to visit a doctor soon if you have any problems. They may conduct a physical exam to get to the roots of the problem. It is unnecessary to go through all the tests to detect PCOS. The tests are selected based on the problems faced by the woman.

Some women with PCOS may not have symptoms other than irregular periods. It is important to remember that irregular periods are not just caused due to PCOS, but a lot of other problems can cause it. One such problem is increased or decreased hormone levels in the female body.

Therefore, diagnosing before jumping to a conclusion is very important. Your doctor is the best person to guide you through the process and also the best person to advise you in this matter.

Do not completely rely on everything that you read online.

6. Causes Of PCOS

As mentioned earlier, the exact cause of polycystic ovary syndrome is unknown. However, some factors can lead to the condition of PCOS. The factors that lead to this condition are mentioned below.

6.1. Resistance To Insulin

Like every other hormone in the body, insulin is also a hormone. This hormone is secreted by the pancreas and is responsible for keeping the sugar levels in the blood. Its main work is to help glucose move from the blood to the cells in our bodies. in the cells, the glucose is broken down into energy.

Being insulin-resistant means that the tissues of our body are resistant to the effects caused by insulin. The body produces more insulin ⁴to compensate for this condition’s problem.

When more insulin is produced in our bodies, it makes the ovary bound to produce more testosterone, which in turn causes interference in the formation of follicles in the female body. When the body is disturbed in making follicles, it hampers the normal ovulation process in females. 

Being insulin-resistant causes PCOS and is the main reason for many other health problems like diabetes. Being overweight is also one of the reasons for insulin resistance. As more amount of fat in the body produces more insulin.

6.2. Hormonal Imbalance

Hormonal imbalance is another leading cause of PCOS. The increase in the levels of the following hormones contributes to the development of polycystic ovary syndrome in the female body.

• Testosterone

• Luteinizing hormone

• Sex hormone-binding globulin

• prolactin

The actual reason why this change in hormonal levels occurs is still unknown. In some of the cases, it has been seen that the problem originates in the ovary itself. In other cases, the problem starts in the adrenal glands or the specific brain parts that handle their secretion.

6.3. Genetics

In some cases, polycystic ovary syndrome can be caused as it runs in the genes.

If anyone in your family history, like your mother, sister, grandmother, or aunt, has polycystic ovary syndrome, you will likely get infected. In these cases, the risk factors of developing this disease increase.

7. Diagnosis Of Pcos

Some tests are required to identify polycystic ovary syndrome. The test is prescribed based on the symptoms that the person shows. Physical exams and blood tests are the most commonly prescribed tests to diagnose PCOS. In some cases, doctors also prescribe pelvic exams or ultrasounds to identify the risk factors.

Let us take a look at the tests individually.

7.1. Medical History And Examination

Before prescribing medicine, going through your medical history is important for every doctor. It is so because it has been seen that people with other health problems and PCOS are resistant to some of the medicines the doctors prescribe.

In some cases, if a woman is facing any other severe health crisis apart from PCOS, the doctor suggests curing the pre-existing crisis before treating PCOS.

The doctors also go through your body mass index before they start the diagnosis of PCOS.

7.2. Hormonal Blood Tests

In most cases, polycystic ovary syndrome can be identified by performing various blood tests. It is so because blood tests determine the androgen levels in the body.

Hyperandrogenism is related to high androgen levels. Performing blood tests is the best way to determine the testosterone level, also known as the male sex hormone. It is also the most effective way to find out whether you are suffering from hyperandrogenism ⁵or not.

Some other blood tests are useful in finding the high androgen levels in the bodies. They are

• SHBG or Sex Hormone Binding Globulin

• DHEAS or dehydroepiandrosterone sulfate

• androstenedione

Apart from checking the levels of androgen in the blood, several other tests are executed to find the levels of various other hormone levels in the body. The testing of other hormones include

• oestradiol, which is the testing of the female sex hormone, also known as estrogen

• Luteinizing Hormone (LH)

• Follicle Stimulating Hormone (FSH)

Some other conditions have similar symptoms as those of PCOS. To be sure whether the patients are affected with PCOS, other blood tests are conducted to check the levels of stimulating thyroid hormone (TSH⁶), prolactin, and the hormones related to the adrenal glands.

7.3. Ultrasound

Ultrasound is prescribed in some cases of PCOS. It is a test showing the ovaries, uterus, and pelvis. The ultrasound is prescribed to determine whether ovarian cysts are formed.

Cysts are nothing but the partly developed eggs that stay on the ovaries. The ultrasound is also responsible for finding out whether the ovaries are enlarged or not. In some cases, it is seen that the lining of the womb thickens due to the occurrence of irregular periods. This condition can sometimes be the main cause of womb or endometrial cancer. It is left untreated for a long time and can also be fatal.

Ultrasound is not required if the patient suffering from PCOS is less than 20 years old. In this case, the levels of androgen and other problems are diagnosed without an ultrasound. In case of severe symptoms like excessive hair loss from the scalp, failure to secrete menstrual blood for a long time, and excess hair growth on the face, going through an ultrasound is suggested.

7.4. Transvaginal Ultrasound

Transvaginal ultrasound is the special ultrasound generally performed on sexually active women. In contrast, an abdominal scan is preferred for the ones who are not sexually active.

It is a no-radiation, painless test that uses a pen-shaped probe. This probe has a sensor attached to the tip, which is used for taking clear images of the vagina.

The sensor-tipped probe is inserted into the vagina, producing a much clearer picture than the normal abdominal ultrasound.

7.5. Other Tests

There are many other tests performed along with the test of PCOS. These tests are performed to calculate the risk of developing heart disease and blood sugar because of polycystic ovary syndrome; PCOS has several links with being overweight and insulin resistance.

The other tests, along with the PCOS test, are mentioned below.

• blood tests to measure the level of blood sugar in the body, blood pressure

• tolerance, blood tests/ glucose metabolism

It is suggested to measure the cholesterol and triglyceride levels frequently if diagnosed with PCOS. Additionally, getting your blood pressure and diabetes checked every 1-3 years is recommended to maintain a healthy lifestyle.

8. Treatment

There is no permanent cure for polycystic ovary syndrome, but it can be managed and kept in control. The treatment is different for every person as everyone might not have the same symptoms.

The main treatment methods associated with polycystic ovary syndrome are mentioned below.

8.1. Lifestyle Changes

Losing weight is one of the most helpful ways of controlling polycystic ovary syndrome. People prone to weight gain are more likely to face health problems in the long run due to PCOS.

After working out for some time, check your body mass index. Losing only up to 5% of weight can tremendously benefit PCOS. Imagine if 5% can make a difference; what effect will it consistently have?

Body mass index is nothing but the measurement of weight concerning height. The BMI or Body Mass Index range ranges from 18.5 to 24.9. You can use the BMI calculator to determine whether you fall in the normal weight category.

Maintain a diet and be consistent in working out. You can opt to lose weight by choosing to eat healthily. Your diet must include many green vegetables, fruits, and antioxidants. Make sure to intake a lot of proteins and cut down on junk food as much as possible.

Eating unhealthy food with polycystic ovary syndrome will accentuate the condition, leading to serious health problems. If you cannot figure out what to eat and what proportion to eat, it would be best to consult with a dietician or ask for advice from your trusted person.

8.2. Medicines

Many medicines are available on the market that don’t treat polycystic ovary syndrome or PCOS directly but are effective in reducing some of the major symptoms that PCOS. The following symptoms can be kept under control by medication.

8.2.1. Irregular Menstrual Periods

For this problem, doctors generally suggest taking contraceptive pills or a course of progesterone tablets. Taking these medicines regularly can be effective in making the periods regular, and you will not have to complain about missed periods anymore.

Consuming these medicines regularly also reduces the risk of endometrial cancer or cancer of the womb lining.

8.2.2. Fertility Problems

Fertility problems can be treated with medication. Most doctors suggest women be on medication that has to be taken at the beginning of each cycle for a certain period. Following this religiously will make women ready to conceive.

For unsuccessful cases, IVF treatment or injections are preferred. In these cases, the risk of multiple pregnancies always remains.

8.2.3. Hair Growth And Hair Loss

Unwanted hair growth and hair loss are some of the most common problems women with PCOS face. There are some specific kinds of medicines available on the market that target this condition.

Keeping this symptom in check is also very effective in keeping polycystic ovary syndrome. These medicines generally block the working of the “male hormones” or testosterone which is primarily responsible for excess hair growth.

Apart from hair growth, hair loss is also a major problem in this condition. You might see bald patches on your scalp, but there is nothing to worry about. Taking proper care of your hair will help you to recover these bald patches. 

8.2.4. Surgery

Laparoscopic Ovarian Drilling, or LOD, is a surgical process used to treat people with severe fertility problems.

Facing fertility problems is one of the most common problems in polycystic ovary syndrome. Women who are willing to get pregnant in recent times are suggested to undergo this surgery.

Generally, no risk factors are associated with this surgery, but if a patient faces a complex situation, it is better to consult a good doctor before surgery. 

9. Bottom Line

By now, we hope that your doubt about how is PCOS diagnosed is clear. Though this condition is not completely curable, following a healthy routine and keeping all the factors in mind will help you control this condition.

Getting a proper diagnosis is very important. It will help you in detecting the right problem soon. Make sure to consult a doctor at the earliest whenever you see any changes or symptoms in your body. The sooner your problem is detected, the quicker you can start treatment. 

It has also been seen that many people with PCOS also suffer from bad mental health. No matter the situation, make sure always to keep yourself positive. 

1. Deswal, Ritu, et al. “The prevalence of polycystic ovary syndrome: a brief systematic review.” Journal of human reproductive sciences 13.4 (2020): 261. ↩︎
2. Galicia-Garcia, Unai, et al. “Pathophysiology of type 2 diabetes mellitus.” International journal of molecular sciences 21.17 (2020): 6275. ↩︎
3. Adriaansen, Bas PH, et al. “Challenges in treatment of patients with non-classic congenital adrenal hyperplasia.” Frontiers in Endocrinology 13 (2022): 1064024. ↩︎
4. Rahman, Md Saidur, et al. “Role of insulin in health and disease: an update.” International journal of molecular sciences 22.12 (2021): 6403. ↩︎
5. Meczekalski, Blazej, et al. “Hyperthecosis: an underestimated nontumorous cause of hyperandrogenism.” Gynecological Endocrinology 37.8 (2021): 677-682. ↩︎
6. Kahaly, George J., Tanja Diana, and Paul D. Olivo. “TSH receptor antibodies: relevance & utility.” Endocrine Practice 26.1 (2020): 97-106. ↩︎

Last Updated on February 10, 2024 by Suchi