It can be difficult to diagnose PCOS based on the physical symptoms alone. After all, the symptoms of one woman may be different from another. In addition, PCOS symptoms can also change depending on different stages of life!

However, some common PCOS symptoms which are present in many women with this condition include irregular periods, excess androgen production, and infertility.

But then again, no one can diagnose a woman with PCOS based on these symptoms alone. That’s why a more accurate way to diagnose PCOS is through a series of lab tests!

For now, no single test is specially designed for PCOS (polycystic ovary syndrome). With that being said, performing various lab tests accurately assesses PCOS in case you think you might have PCOS.

PCOS Lab Tests You Need

Let’s take a quick look at important PCOS lab tests that can help a doctor & YOU to get a diagnosis of PCOS:

• Hormonal Blood Tests – In this full hormone panel, the levels of the following hormones are checked in the blood: Testosterone, TSH, FSH, Estrogen, DHEA-S, SHBG, prolactin & LH.
• Vitamin B12 Test – The levels of Vitamin B12 in the body are checked.
• Vitamin D Test – This test checks the serum levels of Vitamin D in the body.
• A1C Test – This test checks the average blood sugar levels in the body over the last 3 months.
• Fasting Glucose Test – In this test, the glucose levels are checked after fasting (not eating anything for 8 hours prior to the test).
• Iron Test – This is also known as the Ferritin blood test and is used to test the body’s iron levels.
• Full Thyroid Panel – If your doctor agrees to run this test, then you can look into any potential thyroid problems, or (and this is best case scenario) rule them out.
• Pelvic Ultrasound – An ultrasound machine checks the structure of your pelvic organs to see if your ovaries are “polycystic” meaning they might contain multiple immature underdeveloped follicles.

1. Hormonal Blood Tests

One of the major PCOS issues is the level of hormonal imbalance in the body. A woman with PCOS commonly has elevated levels of male sex hormones aka androgens like Testosterone.

These high levels of male hormones can hinder the process of ovulation. It also affects the regular menstrual cycle of women, which ultimately leads to difficulty getting pregnant.

Another common symptom of PCOS is excess facial hair, mainly due to high androgen hormone levels in the body!

In addition, PCOS can also lead to higher estrogen (female hormone) production in the body. Over time, high estrogen levels in the body can lead to health complications, and may increase a woman’s chance of getting endometrial cancer.

So, the purpose of getting a full panel hormonal blood test is to check the levels of different male & female hormones in your body.

Anything that’s out of the ordinary (too low or too high) can ultimately affect fertility & your chances of getting pregnant.

2. Vitamin B12 Test

Another common PCOS symptom is having low levels of Vitamin B12 in the body. According to the National Institutes of Health (NIH), B12 concentration levels are low in PCOS patients with insulin resistance & obesity.

In addition, Audrey J Gaskins (researcher & professor of Epidemiology) did a study to evaluate the effectiveness of vitamin B12 on women’s fertility. The study found that Vitamin B12 and folic acid supplements may improve women’s fertility rate!

This test aims to determine the Vitamin B12 levels in the body and whether Vitamin B12 supplementation is required or not!

3. Vitamin D Test

Another common symptom of PCOS is a deficiency of Vitamin D in the body. And, the only way to find the Vitamin D levels is through a blood test.

In fact, around 67-85% of the women with PCOS were found to be Vitamin D-deficient! So if the blood tests show a low level of Vitamin D in the body, then it may mean a diagnosis of PCOS is imminent.

4. A1C Test

This test checks the average sugar levels in the body during the last 3 months. When compared with blood glucose tests (fasting & non-fasting), the A1C test is considered to be accurate in diagnosing diabetes.

Many women with PCOS go on to develop insulin resistance and have higher levels of sugar in the body. These high levels of glucose & insulin resistance lower the fertility rate of women and can exacerbate symptoms like cravings, fatigue, and weight gain.

5. Fasting Glucose Test

This is a fairly straightforward and affordable test in which the blood glucose levels are checked after fasting for 8 hours.

According to the Centers for Disease Control and Prevention (CDC), the normal level of fasting glucose test is 99 mg/dl or lower. Anything higher than this is an indication of prediabetes or even diabetes.

6. Iron Test

PCOS patients may have higher levels of iron (ferritin) in the body. This excess level of iron in the body leads to insulin resistance and problems with glucose metabolism!

In women, the normal range of iron in the body is between 50 – 170 mcg/DL, however this may vary lab to lab. If the blood test shows an elevated level of the body, then that’s yet another symptom that you might want to double check with your primary doctor.

In addition, low iron levels may lead to hair loss (another frustrating PCOS symptom).

7. Full Thyroid Panel

The thyroid panel test is used to check the levels of thyroid & thyroid-stimulating hormones. This includes checking the T4 and the TSH hormones!

The levels of these hormones in the body provide an indication of thyroid function. Women with PCOS may have a thyroid issue in conjunction with their PCOS, and this can lead to hair loss, irregular periods, and infertility.

8. Pelvic Ultrasound

This physical test looks at the structure and any abnormalities in the lower abdomen & pelvis region. Normally, a pelvic ultrasound can be used to check the following organs: The cervix, ovaries, vagina, & fallopian tubes. With PCOS, we’re looking for polycystic ovaries where multiple immature follicles may be present. 

How to Ask a Doctor for These PCOS Lab Tests?

Knowing about all of these tests before you go for the doctor’s appointment can help you a lot! You can ask the doctor politely about your PCOS symptoms and why they should order these tests for you.

And, before you leave the doctor’s office, ask if you can view the lab order written by the doctor. This will allow you to check and confirm that they have indeed written all the above-mentioned lab tests.

The only thing you need to remember is that you are the patient & you are paying THEM money for the Doctor’s appointment!

I know it takes a little courage to ask the doctor to do the right thing. But this is YOUR health and that matters more than thinking about how your doc might feel!

And if the Doctor just outright refuses to get any of most of these tests & you don’t feel confident in their ability, politely ask them to refer you to a doctor with more relevant experience with PCOS! You can do it! Take the first step towards hitting PCOS out of the park.