From the Guidelines
Blood tests for Polycystic Ovary Syndrome (PCOS) investigation should include LH, FSH, prolactin, progesterone, testosterone, androstenedione, DHEAS, and glucose/insulin levels, as these tests help identify hormonal imbalances and metabolic disorders associated with PCOS 1. To investigate PCOS, the following blood tests are recommended:
- LH and FSH levels to assess the LH/FSH ratio, which is often elevated in PCOS (>2:1) 1
- Prolactin levels to rule out hyperprolactinemia, which can contribute to reproductive dysfunction 1
- Progesterone levels to assess ovary function and detect anovulation, a common feature of PCOS 1
- Testosterone and androstenedione levels to evaluate hyperandrogenism, a key diagnostic criterion for PCOS 1
- DHEAS levels to rule out non-classical congenital adrenal hyperplasia, which can cause hyperandrogenism 1
- Glucose and insulin levels to assess insulin resistance and metabolic disorders, which are common in PCOS 1 These tests should be interpreted alongside clinical symptoms such as irregular periods, hirsutism, acne, and weight gain. The most recent and highest quality study 1 emphasizes the importance of accurate androgen measurement in diagnosing PCOS, highlighting the need for reliable and accurate methods for assessing biochemical hyperandrogenism. Early diagnosis through these blood tests allows for timely intervention with lifestyle modifications or medications, improving morbidity, mortality, and quality of life outcomes for women with PCOS.
From the Research
Blood Tests for PCOS Investigation
The following blood tests are used to investigate Polycystic Ovary Syndrome (PCOS):
- Luteinizing hormone (LH) levels 2, 3, 4
- Follicle-stimulating hormone (FSH) levels 2, 3, 4
- LH/FSH ratio 4
- Total testosterone levels 3, 4
- Derived free testosterone levels 4
- Sex hormone binding globulin (SHBG) levels 3, 4
- Androstenedione levels 4
- Dehydroepiandrosterone (DHEA) levels 4
- Thyroid-stimulating hormone (TSH) levels 2
- Prolactin levels 2
Key Findings
- Elevated levels of LH, FSH, and prolactin, along with increased body mass index and waist-to-hip ratio, are predictors of PCOS and early metabolic abnormalities 2
- Insulin has a positive relationship with LH and testosterone in PCOS patients 3
- Total testosterone is the most frequently abnormal biochemical marker for PCOS, and the combination of testosterone, androstenedione, or LH can be used as definitive hormonal tests 4