Dear Sammy,

Thank you for writing into the PCOS Support blog.

Unfortunately there is no online test that can definitively diagnose PCOS. Only a doctor that performs an examination and lab work will be able to diagnose PCOS in most cases. However, because PCOS is complicated, I would recommend that if you suspect that you do have PCOS based on experiencing some of the symptoms, that you see a doctor that specializes in PCOS.

In the meantime, you can take our online test that assesses your risk of having PCOS, not a diagnosis but depending on the your answers it may be likely and can help you then take the next step of seeing your doctor. http://pcos.insulitelabs.com/PCOS-Self-Test.php

As you have seen, there are many symptoms associated with PCOS. But some of these can be associated with other health conditions and ruling out other health conditions might leave PCOS as the likely diagnosis.

PCOS is notoriously difficult to diagnose. It is a diagnosis of exclusion. In other words, it is important to rule out other diseases that can cause symptoms similar to PCOS (such as Congenital Adrenal Hyperplasia, Cushing’s disease). To diagnose PCOS, we use a combination of clinical symptoms (what you experience as the patient, such as excess hair growth, irregular menses, acne, skin tags, weight gain, infertility, etc.) and lab tests.

The blood tests to consider are:

- free testosterone- elevated in PCOS

- DHEA-S- often elevated in PCOS

- Sex Hormone Binding Globulin (SHBG)- usually low in PCOS

- Fasting insulin- elevated in PCOS. Some doctors may hesitate to order this test because the normal range (0-20) is so wide. However, we find that results greater than 9 indicate insulin resistance. Insulin resistance is usually the underlying cause of PCOS, as you may have read about on our site. Some doctors may also order a 2-hour post-prandial insulin test, along with a 2-hour post-prandial glucose test. For the post-prandial insulin, results over 25 or 30 may indicate insulin resistance.

- Fasting glucose or 2-hour post-prandial glucose test- elevated in PCOS. Using this information in combination with the insulin levels helps to diagnose insulin resistance. Also, women with PCOS have a higher risk of diabetes so it is important to screen for this early and often.

- LH: FSH- Some doctors may also look at the ratio between these two hormones. In PCOS, we would expect LH to be elevated in comparison to FSH.

- You could get an ultrasound to check for the presence of ovarian cysts. Even if the ovaries do appear normal, the absence of ovarian cysts does not mean that you don’t have PCOS. Not everyone with PCOS has ovarian cysts.

- I would also check your cholesterol levels and liver function tests, as these can also be abnormal in PCOS (as well as in many other conditions).

Your doctor may also choose to look at other hormones (estrogen, progesterone).

Sammy, I hope that this gives you more information. If you do have the workup and you are looking for a comprehensive non-pharmaceutical approach to addressing PCOS, please consider the Insulite PCOS System. It not only helps to decrease what symptoms you experience but also addresses the underlying cause, insulin resistance. To read more please visit our website: http://pcos.insulitelabs.com/

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Best Wishes,
Dr. Heather DeLuca, ND
Insulite Laboratories Consulting & Advisory teams

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of being informative. This information is not and
should not be used or relied upon as medical advice.
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