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How to get Tested For PCOS: Diagnosis Guide

By: Aashay Edwin Maghi (CPT)

PCOS can quietly disrupt hormones, causing irregular periods and unwanted symptoms—early testing helps you reclaim balance and well‑being. Knowing your status allows timely treatment to prevent diabetes, heart issues, and fertility struggles.  

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Why Getting Tested Matters

Doctors use the Rotterdam Criteria: you need at least two out of three features—irregular ovulation, elevated androgens, or polycystic ovaries on ultrasound. This standard ensures accurate PCOS diagnosis by combining symptoms, lab tests, and imaging.  

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The Rotterdam Criteria Explained

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Your doctor will ask about menstrual cycles, weight changes, acne, and hair growth—your honest history helps spot PCOS patterns. Keep a cycle journal for a few months to reveal irregularities that warrant testing.  

Medical History & Symptom Tracking 

Step 1

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During a physical exam, your provider checks for excess hair, acne, and signs of insulin resistance (dark skin patches or skin tags). Measuring blood pressure, weight, and waist circumference also highlights PCOS‑related metabolic risks.  

Physical Examination 

Step 2

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Blood tests measure key hormones—like testosterone, LH (luteinizing hormone), and FSH (follicle‑stimulating hormone)—to check for imbalances. Elevated androgens or a high LH:FSH ratio often point to PCOS, but levels vary across cycles.

Hormone Blood Tests 

Step 3

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Ask for tests including total and free testosterone, DHEA‑S, SHBG (sex hormone–binding globulin), and 17‑hydroxyprogesterone to rule out similar conditions. Measuring AMH (anti‑Müllerian hormone) helps assess ovarian reserve and polycystic morphology risk.  

Key Hormone Panels to Order

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PCOS is linked to insulin resistance—your doctor may order fasting glucose, glucose tolerance, and HbA1c tests.. Thyroid function (TSH) and prolactin levels must be checked to exclude thyroid disorders or hyperprolactinemia..

Metabolic & Thyroid Screening 

Step 4

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A transvaginal ultrasound images ovaries, counting follicles (often ≥12 per ovary) and noting ovarian volume. Seeing multiple small follicles (“string of pearls”) supports PCOS diagnosis when combined with lab findings.

Pelvic Ultrasound 

Step 5

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Tests for congenital adrenal hyperplasia (17‑hydroxyprogesterone), Cushing’s syndrome (cortisol), and androgen‑secreting tumors ensure you have PCOS—not another disorder. Your doctor may also check lipid panels to assess cardiovascular risk common in PCOS.  

Rule Out Other Condition

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If tests confirm PCOS, consult a gynecologist or reproductive endocrinologist to discuss personalized treatment—lifestyle, medications, or fertility options. Partnering with a dietitian and mental‑health counselor helps you manage weight, insulin resistance, and emotional well‑being.  

Working With Specialists 

Next Steps

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Does PCOS Cause Infertility? What to Know 

By: Aashay Edwin Maghi (CPT)