Polycystic ovary syndrome (PCOS) is diagnosed primarily based on clinical criteria combined with physical exams, blood tests, and imaging studies. There is no single definitive test for PCOS. The diagnosis usually requires meeting at least two of the following three criteria:
- Irregular or infrequent menstrual periods indicating irregular ovulation or no ovulation.
- Signs of elevated androgen levels (male hormones), either clinically (excess hair growth, acne, thinning scalp hair) or confirmed by blood tests.
- Presence of multiple small cysts (follicles) on one or both ovaries seen on ultrasound.
The diagnostic process typically involves:
- Medical History and Symptom Review: The healthcare provider asks about menstrual cycle irregularities, symptoms of androgen excess, weight changes, and other relevant health history.
- Physical Exam: This includes a pelvic exam to check reproductive organs and an assessment for signs of excess androgen such as hirsutism (excess hair growth), acne, or hair thinning.
- Blood Tests: These measure hormone levels to detect elevated androgens and to rule out other conditions that mimic PCOS. Additional tests may screen for diabetes or cholesterol issues.
- Ultrasound: A transvaginal ultrasound is used to visualize the ovaries for multiple follicles (often described as cysts) and to assess the uterine lining.
A diagnosis of PCOS is made when at least two of the three criteria are met, after excluding other possible causes of the symptoms. Not all patients require an ultrasound if the other criteria are clearly present. Following diagnosis, patients may be managed by a general practitioner or referred to specialists such as gynecologists or endocrinologists for further care and treatment planning
