Is it PCOS - How is it diagnosed
I run blood work on the majority of patients in my office. I am a huge believer in testing, not guessing! I don’t like to poke around in the dark, guess, or waste time when it comes to my patients' treatments. I want to know EXACTLY what is going on.
As a Naturopathic Doctor whose practice heavily focuses on hormones, I commonly meet women who experience symptoms that resemble PCOS. The question ends up becoming, is it PCOS?
What Are the Common Symptoms Of PCOS?
COMMON SYMPTOMS ARE...
Not all women will experience all of these symptoms, in fact, many will experience them to varying degrees and severities. As a general rule, if you are experiencing any of these symptoms it's time for you to be worked up for PCOS!
- Hormonal based acne
- Darkened Facial Hair
- Irregular or absence periods (aka oligomenorrhea or amenorrhea)
- Hair loss on the scalp
- Weight Loss Resistance
- Infertility
- Ovarian Cysts found on pelvic ultrasound
- And Painful periods, just to name a few
How is PCOS Diagnosed?
PCOS is diagnosed based on something called the Rotterdam criteria. You only need to satisfy 2 out of the 3 findings to be diagnosed with PCOS.
Hyperandrogenism (aka, acne, darkened facial hair)
Oligomenorrhea (Irregular periods, > 35-day cycle)
Polycystic Ovaries (finding 12+ small cysts on pelvic ultrasound that resemble a string of pearls.]
This means that despite the name, it is possible to have PCOS without cysts on your ovaries. For these reasons I always combine this criterion with a proper physical exam, health history and lab work!
The Lab Work You Need To Run If You Think You May Have PCOS
To properly interpret these lab results you must run them on specific days of menses.
The following tests should be run on the 3rd-5th day of menses.
FSH & LH
Estradiol
DHEAS
Prolactin
17-OH
Progesterone
These lab tests can be run at any part of the menstrual cycle, but ideally, they should be completed fasted in the morning.
The following tests should be run on the 3rd-5th day of menses.
B12
Ferritin
ESR
CRP
Testosterone (Total & Free)
Full Thyroid Panel
Fasting Insulin & Glucose
These tests can are also used to rule out other disorders that may mimic PCOS. This includes elevated prolactin, Congenital Adrenal Hyperplasia (CAH) and thyroid disorders to name a few.
Getting properly diagnosed and worked up for PCOS is the first step toward your hormonal healing journey!
Are you looking for someone to run this lab work for you? Don’t know how to interpret your results? Let’s chat, I can show you how lab work can be an empowering tool when it comes to your hormonal health!
Apply to work with me!
Dr. Michelle Webb
Your Hormone & Gut Health Naturopathic Doctor
Rasquin Leon LI, Anastasopoulou C, Mayrin JV. Polycystic Ovarian Disease. [Updated 2022 May 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459251/
