How is Polycystic Ovarian Syndrome Diagnosed?

Polycystic ovarian syndrome (PCOS), is caused by an overproduction of male hormones (called androgens) in women. The condition affects women during their fertile years - during the time a woman menstruates. PCOS is mainly associated with menstrual irregularities, amenorrhoea (no periods) or heavy menstruation. 

The majority of women with PCOS see excessive hair growth in places where they may not want hair to grow, such as their upper lip, back, chin or chest. The hair on their head might thin out, however. They might also experience weight gain, oily skin or acne. 

How Do You Know If You Have PCOS Or Just Cysts?

The formation of cysts on the ovaries is actually a normal part of ovulation. The egg is released from a fluid-filled cyst, called a follicle. The problem comes in when there is a hormonal imbalance. If the message to release the egg doesn’t reach the follicle in time and the cyst continues to grow, becoming large and painful. 

You can experience an ovarian cyst without having PCOS. You can also have PCOS without having large ovarian cysts. 

The condition is usually diagnosed when there is a combination of symptoms associated with PCOS: 

• Enlarged ovaries or ovaries filled with numerous cysts 
• Hirsutism (excess body hair)
• Acne-prone or oily skin
• Hair loss (male-pattern baldness)
• Skin tags 
• Amenorrhoea or irregular periods
• Weight gain around the stomach area
• Dark or thick patches on the skin

In general, the diagnosis will include three criteria: increased androgen production, dysfunction of the ovaries (which may include anovulation) and ovarian cysts. Usually, if you have 2 out of the 3 criteria, you will be diagnosed with PCOS. 

What Do PCOS Cysts Feel Like?

The cysts associated with PCOS usually cause uncomfortable abdominal bloating. It might feel like pressure or pain in the lower portion of the abdomen on the side of the affected ovary. The pain is usually inconsistent. If the cysts are small, you might not feel it at all. If any of the cysts are large and they rupture, you may feel severe and sudden pain on the affected side. 

Which Tests are Done to Diagnose PCOS?

A detailed medical history of yourself and your family will help your doctor gauge the risk of PCOS. It will also help to establish a timeline and severity of your symptoms, so making a diary entry when you experience symptoms will help your doctor understand your condition. 

Your doctor may conduct a pelvic exam, a physical exam, an ultrasound and blood tests. All of these detection methods are relatively non-invasive.

Which Blood Tests Show PCOS?

Your doctor will request a testosterone blood test and a free androgen index (FAI). This will determine if your androgen levels are too high (hyperandrogenism), which is one of the indicators of PCOS. 

There are other blood tests which will also indicate high androgen levels such as: SHBG (sex hormone-binding globulin), DHEAS (dehydroepiandrosterone sulphate) and androstenedione. 

Some blood tests may also be performed to exclude the PCOS diagnosis since the symptoms are similar to other diseases as well. For example: TSH (thyroid-stimulating hormone), prolactin and hormones associated with adrenal functions.

Are Polycystic Ovaries Seen On Ultrasound?

Yes, an ultrasound allows your doctor to see what the ovaries look like and if there are cysts present. The size of the ovaries will also be determined by this test. 

Ultrasounds are non-invasive. They use sound waves and a computer to generate a visual image of the various organs and blood vessels. At the same time, the doctor will look at the uterus lining, which is called the endometrium, to make sure it is the correct thickness according to your menstrual cycle and day in your cycle and to exclude other possible causes.

Can I Test For PCOS at Home?

There are home tests available to test your androgen levels, but consulting with a doctor can help to confirm your diagnosis. A doctor will also be able to investigate the cause of your symptoms and help you manage the condition with a treatment plan.