PCOS Lab Tests

By. Dr. Samina Mitha, ND

PCOS or Polycystic Ovarian Syndrome is an endocrine disorder that can affect hormones, metabolism and the immune system. Getting a comprehensive lab test is the first step to really understand what is going on with your hormones. Having gone through the process myself each year, I wanted to share with you the list of PCOS lab tests that I believe are important to ask for when you are talking to your doctor.

I have divided the PCOS lab tests up into sections based on different hormones.

PCOS Lab Tests

1. Glucose Metabolism:

When you eat something that contains long strands of glucose the body will break it down into individual glucose molecules. This will signal the pancreas to release insulin. Insulin’s job is to take the glucose and shuttle it into the cells to be used for energy. If the cells do not become responsive to insulin it can result in “insulin resistance.” This results in a build of insulin and glucose in the blood stream. It is important to check out how well your body is processing insulin and glucose because it can cause an increase in testosterone therefore worsening your PCOS.

1. Fasting Insulin
2. Fasting Glucose
3. HbA1c
4. Oral Glucose Tolerance test

2. Testosterone:

Androgens are known as testosterone and similar hormones. They are one of the most important factors of PCOS. Androgens are known to be essential to women’s health. Androgens are required to build muscle mass, maintain libido, and support kidney, bone and heart health. Major symptoms of high androgens include, hair growth, hair loss and acne.

1. Free testosterone – produced in the adrenal glands, ovaries and in the blood stream
2. Total testosterone
3. DHEA-S – produced in the adrenal glands, and small amounts in the ovaries
4. Androstenedione – produced in the ovaries and the adrenal glands

3. Reproductive Hormones: 

Estrogen is required in the first half the cycle to build the follicle that will eventually release an egg during ovulation. Progesterone is predominant in the second half of the cycle after ovulation occurs. These hormones are important to see if a women is building a strong follicle and if she is ovulating.

1. Estradiol
2. 17-hydroxyprogesterone

4. Pituitary Gland Hormones:

The pituitary gland that sits in our brain produces FSH and LH. The function of FSH is to prepare the follicle for ovulation. As estrogen rises high in the cycle before ovulation, the LH surge occurs so that the egg can be released from the follicle. These two are important to test because it is common to see a ratio of 3:1 or 2:1 LH:FSH on Day 3 of the cycle in PCOS women.

Prolactin is released by the pituitary and signals to the mammary glands to produce milk. High levels of androgens can result in high prolactin.

1. Follicle Stimulating Hormone (FSH)
2. Luteinizing Hormone (LH)
3. Prolactin

5. Thyroid Health:

There is a large overlap between PCOS symptoms and thyroid syndrome. Each condition can worsen one another. Additionally, low thyroid function can aggravate insulin resistance. So it is important to get your thyroid checked.

1. Thyroid Stimulating Hormone (TSH)
2. T4
3. T3
4. Anti-thyroperiodiase

Additional Tests:

• AMH – Anti-Mullerian Hormone
• Lipid/Cholesterol Panel
• CRP – marker of inflammation
• Cortisol curve – to investigate how well your body is producing cortisol in times of stress

These PCOS lab tests are meant to service as a guide. Please speak to your healthcare provider to determine which tests are required.

For more articles on PCOS click here.