There is no single definitive test to diagnose PCOS. Diagnosis will usually be made by considering the following:

• Symptoms
• Hormonal testing including androgen , LH and FSH, and insulin levels
• An ultrasound to look for cysts and enlargement of the ovaries

Many women go for a long time without being diagnosed with PCOS as they don’t consider their symptoms to be related, and seek treatment for them one at a time. Medical treatment is commonly sought for symptoms including irregular periods, infertility, acne, hirstuism or weight gain and difficulties with weight loss.

Other possible causes of irregular menstruation and excessive hair growth such as Cushing’s Syndrome and congenital adrenal hyperplasia or other disorders of the pituitary or adrenal glands should by ruled out.

In 2003, new consensus guidelines were developed which state that diagnosis of PCOS requires the presence of two out of three of the following:

1. Oligo- or anovulation (this means irregular or absent menstrual periods).

2. Clinical and/or biochemical signs of hyperandrogenism (this means high levels of male hormones on a blood test or signs of increased male hormone levels such as acne and excess hair).

and

3. Polycystic ovaries (seen on ultrasound)

with the exclusion of other conditions such as congenital adrenal hyperplasia, androgen-secreting tumours and Cushing’s syndrome.

(The Rotterdam ESHHRE/ASRM-Sponsored PCOS Consensus Workshop Group, 2003).

While testing for insulin resistance is not part of these guidelines, many doctors will also do a Glucose Tolerance Test (GTT) to test for high insulin levels, which are commonly seen in women with PCOS.  Due to their increased risk of type 2 diabetes, the NH&MRC (National Health and Medical Research Foundation) and Diabetes Australia recommend screening for diabetes in all women with PCOS who are overweight.

For more information or to make an appointment, please email info@pcoshealth.com.au or call 9904 8169.