PCOS Tests
PCOS Tests PCOS is to some extent a diagnosis of exclusion. There is not a specific -*test*-('") that can be used to diagnose PCOS and there is not widespread agreement on what the diagnostic criteria should be. Your doctor will do -*test*-('")s to rule out other causes of anovulation and infertility. He will usually order a variety of hormone -*test*-('")s to help determine whether hormone overproduction may be due to PCOS, an adrenal or ovarian tumor, or an overgrowth in adrenal tissue (adrenal hyperplasia). Ultrasounds are often used to look for cysts in the ovaries and to see if the internal structures appear normal. Your doctor will be looking for a combination of laboratory results and clinical findings that suggest PCOS. If you are diagnosed with PCOS your doctor may order -*test*-('")s such as lipid profiles and glucose levels to monitor your risk of developing future complications such as diabetes and cardiovascular disease Laboratory Tests * FSH (Follicle Stimulating Hormone), will be normal or low with PCOS * LH (Lutenizing Hormone), will be elevated * LH/FSH ratio. This ratio is normally about 1:1 in premenopausal women, but with PCOS a ratio of greater than 2:1 or 3:1 may be considered diagnostic * Prolactin will be normal or low * Testosterone, total and/or free, usually elevated * DHEAS (may be done to rule out a virilizing adrenal tumor in women with rapidly advancing hirsutism), frequently mildly elevated with PCOS * 17-ketosteroids (urine metabolites of androgens, used to evaluate adrenal function) elevated or decreased? * Estrogens, may be normal or elevated * Sex hormone binding globulin, may be reduced * Androstenedione, may be elevated * hCG (Human chorionic gonadotropin), used to check for pregnancy, negative * CMP (Comprehensive metabolic panel) * Lipid profile (low HDL, high LDL, and cholesterol, elevated triglycerides) * Glucose, fasting or a glucose tolerance, may be elevated * Insulin, often elevated * TSH (Thyroid stimulating hormone) some who have PCOS are also hypothyroid Non-Laboratory Tests Ultrasound, transvaginal and/or pelvic/abdominal are used to evaluate enlarged ovaries. With PCOS the ovaries may be 1.5 to 3 times larger than normal, and characteristically have more than 8 follicles per ovary, with each follicle less than 10 mm in diameter. Often the cysts are lined up on the surface the ovaries, forming the appearance of a "pearl necklace." These ultrasound findings are not diagnostic. They are present in more than 90% of women with PCOS but they are also found in up to 25% of women without PCOS. Laparoscopy may be used to evaluate ovaries, evaluate the endometrial lining of the uterus, and sometimes used as part of surgical treatment. PCOS email this page print this page What is it? Signs & symptoms Tests Treatments Sources Treatments There is no cure for PCOS. Although there have been cases involving the spontaneous resumption of menses, most women will have progressive symptoms until after menopause. Treatment of PCOS is aimed at reducing its symptoms and helping to prevent future complications. The goals are to promote ovulation, prevent endometrial hyperplasia, counterbalance the effects of androgen, and reduce insulin resistance. Treatment options depend on the type and severity of the individual patient's symptoms and on the patient's desire to become pregnant. Low-dose oral contraceptives are often used to stabilize hormones and oppose estrogen. Within several months they can usually regulate menstrual periods, eliminate or minimize uterine bleeding, and reduce androgen levels (improving hirsutism and clearing up acne). Antiandrogens, such as spironolactone (Aldactone), flutamide (Eulexin) and cyproterone (Cyprostat) are sometimes combined with oral contraceptives to help address more severe hirsutism and acne. Waxing, shaving, depilatory and electrolysis may be used to remove unwanted hair, and antibiotics or retinoic acids may be used to treat acne. Metformin (Glucophage) is being used to increase insulin sensitivity. It has also shown promising initial results in women with PCOS hirsutism, and in helping to regulate menstrual cycles but its effects on infertility and other symptoms are not yet known. Weight loss and exercise are recommended to help decrease insulin resistance and to minimize lipid abnormalities. Weight reduction can also decrease -*test*-('")osterone, insulin, and LH levels. Although sometimes performed, surgery is a rare PCOS treatment option. One surgical option, a "wedge resection", involves removing the part of the ovary that contains the cystic follicles to try to restore ovulation. Another option, ovarian drilling, involves using needle with an electric current to make holes in the ovary. Both of these procedures may temporarily increase fertility but may also lead to scarring and adhesions If a woman with PCOS wants to become pregnant, she is usually given clomiphene citrate (Clomid), a drug that helps induce ovulation. She may also be given human menstrual gonadotropin (Pergonal), although this drug increases the risk of multiple pregnancies.
PCOS Tests PCOS is to some extent a diagnosis of exclusion. There is not a specific -*test*-('") that can be used to diagnose PCOS and there is not widespread agreement on what the diagnostic criteria should be. Your doctor will do -*test*-('")s to rule out other causes of anovulation and infertility. He will usually order a variety of hormone -*test*-('")s to help determine whether hormone overproduction may be due to PCOS, an adrenal or ovarian tumor, or an overgrowth in adrenal tissue (adrenal hyperplasia). Ultrasounds are often used to look for cysts in the ovaries and to see if the internal structures appear normal. Your doctor will be looking for a combination of laboratory results and clinical findings that suggest PCOS. If you are diagnosed with PCOS your doctor may order -*test*-('")s such as lipid profiles and glucose levels to monitor your risk of developing future complications such as diabetes and cardiovascular disease Laboratory Tests * FSH (Follicle Stimulating Hormone), will be normal or low with PCOS * LH (Lutenizing Hormone), will be elevated * LH/FSH ratio. This ratio is normally about 1:1 in premenopausal women, but with PCOS a ratio of greater than 2:1 or 3:1 may be considered diagnostic * Prolactin will be normal or low * Testosterone, total and/or free, usually elevated * DHEAS (may be done to rule out a virilizing adrenal tumor in women with rapidly advancing hirsutism), frequently mildly elevated with PCOS * 17-ketosteroids (urine metabolites of androgens, used to evaluate adrenal function) elevated or decreased? * Estrogens, may be normal or elevated * Sex hormone binding globulin, may be reduced * Androstenedione, may be elevated * hCG (Human chorionic gonadotropin), used to check for pregnancy, negative * CMP (Comprehensive metabolic panel) * Lipid profile (low HDL, high LDL, and cholesterol, elevated triglycerides) * Glucose, fasting or a glucose tolerance, may be elevated * Insulin, often elevated * TSH (Thyroid stimulating hormone) some who have PCOS are also hypothyroid Non-Laboratory Tests Ultrasound, transvaginal and/or pelvic/abdominal are used to evaluate enlarged ovaries. With PCOS the ovaries may be 1.5 to 3 times larger than normal, and characteristically have more than 8 follicles per ovary, with each follicle less than 10 mm in diameter. Often the cysts are lined up on the surface the ovaries, forming the appearance of a "pearl necklace." These ultrasound findings are not diagnostic. They are present in more than 90% of women with PCOS but they are also found in up to 25% of women without PCOS. Laparoscopy may be used to evaluate ovaries, evaluate the endometrial lining of the uterus, and sometimes used as part of surgical treatment. PCOS email this page print this page What is it? Signs & symptoms Tests Treatments Sources Treatments There is no cure for PCOS. Although there have been cases involving the spontaneous resumption of menses, most women will have progressive symptoms until after menopause. Treatment of PCOS is aimed at reducing its symptoms and helping to prevent future complications. The goals are to promote ovulation, prevent endometrial hyperplasia, counterbalance the effects of androgen, and reduce insulin resistance. Treatment options depend on the type and severity of the individual patient's symptoms and on the patient's desire to become pregnant. Low-dose oral contraceptives are often used to stabilize hormones and oppose estrogen. Within several months they can usually regulate menstrual periods, eliminate or minimize uterine bleeding, and reduce androgen levels (improving hirsutism and clearing up acne). Antiandrogens, such as spironolactone (Aldactone), flutamide (Eulexin) and cyproterone (Cyprostat) are sometimes combined with oral contraceptives to help address more severe hirsutism and acne. Waxing, shaving, depilatory and electrolysis may be used to remove unwanted hair, and antibiotics or retinoic acids may be used to treat acne. Metformin (Glucophage) is being used to increase insulin sensitivity. It has also shown promising initial results in women with PCOS hirsutism, and in helping to regulate menstrual cycles but its effects on infertility and other symptoms are not yet known. Weight loss and exercise are recommended to help decrease insulin resistance and to minimize lipid abnormalities. Weight reduction can also decrease -*test*-('")osterone, insulin, and LH levels. Although sometimes performed, surgery is a rare PCOS treatment option. One surgical option, a "wedge resection", involves removing the part of the ovary that contains the cystic follicles to try to restore ovulation. Another option, ovarian drilling, involves using needle with an electric current to make holes in the ovary. Both of these procedures may temporarily increase fertility but may also lead to scarring and adhesions If a woman with PCOS wants to become pregnant, she is usually given clomiphene citrate (Clomid), a drug that helps induce ovulation. She may also be given human menstrual gonadotropin (Pergonal), although this drug increases the risk of multiple pregnancies.