There is no single test that can be used to diagnose polycystic ovary syndrome (PCOS). Instead, there are various factors that should be considered, and a diagnosis can be made based upon the findings from the observations and tests.
For a diagnosis of PCOS to be made, at least two of the following criteria must be met:
- Irregular or absence of menstrual periods
- High levels of androgen hormones evident in blood test results
- Ultrasound scan with evidence of polycystic ovaries
Family and Medical History
As women with a family history of certain medical conditions are more likely to be affected by PCOS, these should be considered in the initial consultation. Conditions that are associated with PCOS include:
- Menstrual disorders
- Adrenal enzyme deficiency
- Obesity and metabolic syndrome (e.g., diabetes)
It is also important to discuss signs and symptoms that the woman has noticed that may be indicative of PCOS in the consultation. Abnormal patterns or absence of menstruation is characteristic of women with the condition. Likewise, difficulty conceiving due to irregular ovulation is a common reason that women may seek medical advice for and eventually be diagnosed with PCOS.
There are several physical characteristics that should be considered during the diagnostic process for PCOS. These signs are not unique to PCOS and cannot, therefore, be used to diagnose the condition alone but can be useful to take into consideration.
Raised levels of androgen hormone in women with PCOS can affect skin and hair growth. Hirsutism is a condition involving excessive hair growth on the face, chest, back, or buttocks due to these hormonal changes. Signs of abnormal hair growth in these areas may be indicative of PCOS. Also linked to the raised androgen hormone levels are changes in the consistency of the skin, which can become oilier. As a result, many affected women suffer from acne.
Almost half of the women affected by PCOS are obese and weight should, therefore, be considered as a factor when making a diagnosis of the condition.
Additionally, some affected women will have evidence of thickening and hyperpigmentation in some areas of the skin, such as the neck, under the breasts, and on the elbows.
Hypertension is common in women with PCOS and can increase the likelihood of heart disease, stroke, and diabetes. Therefore, blood pressure is usually checked during diagnosis.
A blood sample can be analyzed to measure the levels of hormones in the blood, which may be indicative of PCOS. This can also provide valuable information about common complications of the condition, such as diabetes or high cholesterol.
Some women with PCOS may have enlarged ovaries and investigating the presence of ovarian mass is necessary. This may be done with an ultrasound scan of the area. An ultrasound can also help to visualize the number of follicles in the ovaries, which is a distinctive characteristic of PCOS.
If a diagnosis of PCOS is made, the woman is usually referred to a specialist who has experience managing the condition. Most women require ongoing care and support and should be monitored for early signs of complications associated with the syndrome.
Reviewed by Susha Cheriyedath, MSc