PCOS Diagnosis

How is PCOS Diagnosed?

There is no one special test that can determine a PCOS diagnosis. Instead, doctors must rely on symptoms, blood tests, a physical exam, and sometimes a pelvic ultrasound to determine whether you have polycystic ovary syndrome – rather than another condition that can trigger similar signs and symptoms.

Your doctor will start by asking questions about your medical history of symptoms such as irregular or skipped periods, weight changes, hair changes, and acne. 

While some women with PCOS have several telltale signs of this metabolic condition caused by multiple hormone imbalances, others may have just two or three symptoms. It’s important to let your doctor know about any and all of the health issues and concerns you have been experiencing. 

Medical History and Tests

Your doctor will also ask about your family’s medical history. Your doctor will check your weight and vitals and do a complete physical exam. A number of lab tests may be ordered including blood sugar and androgen levels. A sonogram may also be done to evaluate the ovaries.

These tests help to make a diagnosis of PCOS and exclude other causes for your symptoms. Doctors may be cautious about delivering a diagnosis for some women (especially those in their teens and early 20s) because symptoms like irregular periods, ovarian cysts, and acne can be a normal part of puberty.

Your primary doctor may also refer you to a hormone specialist, or endocrinologist, to help direct the workup needed to rule out other causes and confirm the diagnosis of PCOS.

An early diagnosis can help women with PCOS restore fertility, normalize their menstrual cycles, and protect against polycystic ovary syndrome-related risks for diabetes, heart disease, and endometrial cancer.

Three Defining Signs of PCOS

● Irregular menstrual periods caused by a lack of ovulation or by irregular ovulation. Periods more than 35 days apart are a strong sign of ovulation problems. 

● Higher than normal androgen levels. Your doctor may look for physical signs of high levels of testosterone  – excess hair, male-pattern hair loss, and severe acne – or use the results of blood tests.  

● Polycystic ovaries on pelvic ultrasound. Thanks to newer, more sensitive ultrasound equipment, experts say doctors should look for 25 or more cysts on a woman’s ovary to diagnose polycystic ovaries.

You can check the summary of the updated guidelines for more information.

What types of health providers understand pcos?

Should You See An Endocrinologist for PCOS? 

What Types of Health Providers Understand PCOS? 

Should you see an endocrinologist for PCOS? There are different health providers who may diagnose and provide care for PCOS or PCOS-related conditions. People often see more than one health provider for PCOS-related issues, but in some cases, they may only have one provider. These health providers include:

Primary care doctor - This is a good place to start! Go to your primary care doctor armed with questions and concerns you may have. Share your symptoms like missed periods or facial hair. They can start you on the right path to treatment or even recommend a specialist.

Gynecologist - This is a doctor who specializes in women’s health, with a focus on the female reproductive system. In addition to treating PCOS, they deal with a wide range of issues, including pregnancy and childbirth, menstruation and fertility issues, sexually transmitted infections (STIs), and more.

Gynecologists can help with irregular menstrual cycles associated with PCOS, often by prescribing birth control pills for those women who aren’t trying to conceive. 

Medical endocrinologist - This is a specially trained doctor who is a hormone specialist with basic training in internal medicine as well, generally considered the specialist for PCOS. Endocrinologists have the training to diagnose and treat hormone imbalances by helping to restore the normal balance of hormones in the body.

Reproductive endocrinologist (RE) - This is a doctor who is a fertility/infertility specialist. They are the only types of doctors trained in providing fertility treatments using assisted reproductive technologies (ART) such as in-vitro fertilization (IVF) and egg freezing. 

Reproductive endocrinologists are also trained in obstetrics and gynecology, with additional training to provide fertility treatment. In addition to diagnosing and treating infertility, REs specialize in the treatment of PCOS. 

A reproductive endocrinologist can manage your PCOS treatment and often do ultrasounds in the office. Since many women with PCOS have difficulty conceiving, this is a good specialist to consider. 

Dermatologist - 

Acne is one side effect of the high androgen levels associated with PCOS. Androgens cause the glands in the skin to produce an excess of an oily substance called sebum. Sebum and dead skin cells build up inside hair follicles. This traps bacteria beneath the skin causing inflammation and nasty breakouts. 

Severe acne can often be treated with a medication called Accutane, which reduces oil production on your skin, slows down the growth of skin cells that clog pores, and kills bacteria in your pores. Some women also choose to try over-the-counter products like creams or lotions. If there are any acne scars remaining, they can be treated with laser therapy.

Psychologist and/or psychiatrist - In addition to having an increased risk of metabolic disorders, women with PCOS show higher rates of anxiety and depression. They may suffer from mood disorders due to an imbalance in hormones or just need to vent about the everyday frustrations of living with this serious condition. 

PCOS is associated with insulin resistance, which can be linked to psychiatric disorders like schizophrenia and bipolar. Some women with PCOS also suffer from borderline personality disorder, poor self-esteem, and eating disorders. 

It’s important to talk to a professional about any concerns you have relating to your PCOS symptoms, fertility struggles, or any other major life issues you may be facing.

Dietician -  

Unfortunately, there’s also a link between PCOS and being overweight. Dietitians play an important role in helping women with PCOS optimize their health and prevent disease by managing diet and lifestyle. PCOS can develop into serious complications like high cholesterol, high blood pressure, type 2 diabetes, and heart disease if diet and lifestyle changes don’t get under control. Dieticians can assist in these nutrition and lifestyle strategies, which is a big part of your lifelong approach to treating PCOS.

Women with PCOS are often recommended to eat anti-inflammatory diets. These special diets include moderate to high amounts of fiber with an emphasis on anti-inflammatory foods such as fish, legumes, green tea, and low-fat dairy. Chicken, red meat, and added sugars should be limited. Mediterranean-style diets, fiber-rich diets, and low-carb diets are some other diets recommended for PCOS.

A registered nutritionist or dietician can provide nutrition education about PCOS, dietary supplements which may help your condition, and develop a personalized meal plan based on your specific needs.

As you can see, while an endocrinologist for PCOS is a great option, there are many other specialists who can provide excellent care.

Find a PCOS Specialist

New to the PCOS Awareness Association Network!

The PCOS Awareness Association is committed to raising awareness about PCOS worldwide. However, we recognize that everyone does not have the same level of access to care and information. The PCOS Directory is intended to help all patients worldwide connect with qualified professionals who can help enhance the quality of life for those suffering from PCOS. The directory also offers professionals and PCOS specialists a free and equal way to network and learn more about each other. The platform will serve as another resource by the PCOS Awareness Association to help support, educate, and advocate for PCOS awareness. You can browse the PCOS specialists who have already been added to the directory online at www.pcosdirectory.org.

Tips on how to talk to your doctor about PCOS

It will help to jot down questions or topics to discuss prior to your doctor's appointment. It is easy to forget things when you are at a medical appointment, so this will help to ensure that all the important items are covered. Anticipate questions your doctor may ask such as:

How your symptoms have been.

What measures have helped?

What changes have been made in your treatment regimen (that you have initiated on your own or as a recommendation from another provider)?

Many women see more than one doctor to help address different aspects of their PCOS. This can lead to feeling frustrated with having to share your PCOS situation over and over with different doctors. Visual aids can help.