Polycystic Ovary Syndrome—Tests, Diagnosis, And Monitoring
Medical checkups are important to stay on top of our health game, and especially when it comes to monitoring issues such as PCOS. We break down what you need to know about polycystic ovary syndrome and tests.
4 per cent to 20 per cent of women of reproductive age worldwide are affected by polycystic ovary syndrome (PCOS), mentions a 2020 review published in the Journal of Human Reproductive Sciences. Not everyone with PCOS shows the exact same manifestations, and it can be an underdiagnosed health issue. So how is PCOS diagnosed?
PCOS is a complex issue, and there is no one definitive test. Rather, your healthcare professional will evaluate your condition based on symptoms presented and a range of tests. Says Dr. Anuradha Panda, senior obstetrician and gynaecologist, Apollo Hospitals, Hyderabad, "When talking about diagnosis, the most important thing is to know an individual's symptoms. We diagnose some clinical symptoms of a patient. The first is, whether they have irregular periods or no periods. Do they have features of hyperandrogenism (increased levels of male hormone), such as more acne, baldness, and unwanted hair. Along with noting these symptoms, an ultrasonography is also done, although ultrasound is not a must for young girls if they have these features."
It is important to see the volume of the ovaries. With PCOS, the ovaries are bulky, and according to an article published in RadioGraphics, the ovarian volume exceeding 10 cm³ (for one or both ovaries) can establish the presence of polycystic ovaries. The number of follicles is another thing considered. For diagnosing and monitoring PCOS, blood tests are also done, as, according to Dr. Panda, "Individuals with PCOS are prone to effects on their blood sugar and blood pressure, as well as heart disease and sometimes, some types of cancer later in life." Here are some associated blood tests.
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1. Free Testosterone Test: "One important test done for diagnosis is free testosterone test, to check the male hormone levels," says Dr. Panda. Free testosterone indicates testosterone that is unattached and more easily used by the body. Elevated levels of testosterone are seen in individuals with PCOS.
2. DHEAS Test: "DHEAS, or dehydroepiandrosterone sulphate, is tested to know whether the DHEAS is coming from the ovary or adrenal gland," Dr. Panda says. DHEA sulphate levels can be high in people with PCOS.
3. Tests for Blood Sugar: PCOS can be associated with insulin resistance and therefore, an increased risk of type 2 diabetes. Fasting insulin test is one of the blood tests done. "Most people with PCOS will present diabetes at a very early age. Tests for HbA1c and fasting sugar are done,” says Dr Panda.
4. Tests for Lipid: An article published in the Taiwanese Journal of Obstetrics and Gynecology presents that lipid abnormalities like elevated LDL ("bad" cholesterol) and triglyceride levels, and reduced HDL ("good" cholesterol) levels are often found in individuals with PCOS. Thus, a lipid profile test is done.
5. Prolactin Test: The hormone prolactin helps in milk production, and raised levels can affect menstruation. "A prolactin level test is done to rule out any other cause and to know why the period is irregular," says Dr. Panda.
6. Thyroid Test: Another test done to rule out other conditions that can have symptoms similar to that of PCOS is checking the levels of thyroid stimulating hormone (TSH).
7. Vitamin D Test: The prevalence of deficiency of Vitamin D in women with PCOS is about 67 to 85 per cent, according to an article published in The Indian Journal of Medical Research. A lack of the vitamin can be associated with worsened symptoms of PCOS.
8. Other Tests: Kidney function tests are also performed for individuals with PCOS. Tests such as AMH (Anti-Müllerian hormone) test and LH and FSH (Luteinizing hormone and Follicle Stimulating hormone) ratio tests are also done sometimes, but they are not mandatory.