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Understanding PCOS Tests: What to Expect and How to Prepare

Written by Andrew Le, MD

UpdatedMay 29, 2024

Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder affecting 116 million women worldwide. Left untreated can lead to various healthcomplications, making early detection and diagnosis crucial.

According to the Office on Women’s Health, around 10% of women in their childbearing years are affected by PCOS. This condition leads to hormonal imbalances and disruptions in metabolism, potentially causing wide-ranging effects on your body and appearance. Importantly, it's a prevalent and manageable factor contributing to infertility.

In this article, you will learn the essential PCOS tests, what to expect, and provide helpful tips on preparing for them.

What is PCOS?

PCOS is a hormonal disorder that disrupts the normal functioning of the ovaries, leading to irregular menstrual cycles and potential fertility issues.

Approximately 5-10% of women aged 18-44 are affected by this common condition.

In a healthy reproductive cycle, the ovaries release an egg each month during the menstrual cycle. However, in women with PCOS, the hormonal imbalance prevents the ovaries from releasing eggs regularly, leading to irregular menstrual cycles. Sometimes, the ovaries may also develop small fluid-filled sacs called cysts, hence the "polycystic ovary."

The exact cause of PCOS is unknown, but it is thought to be related to insulin resistance, which can lead to high levels of insulin in the body. This can cause the ovaries to produce more androgens, which are male hormones commonly present in small amounts in women.

The excess androgens can disrupt the menstrual cycle and lead to the symptoms of PCOS.

Diagnosis of PCOS is typically based on a combination of symptoms, physical examination, and laboratory tests. No test can diagnose PCOS, but several tests can help confirm the diagnosis and rule out other conditions.

Now that we understand PCOS let's talk about its symptoms.

What are the Symptoms of PCOS?

The symptoms of PCOS can vary from person to person, and some women may experience more severe symptoms than others. Some common symptoms of PCOS include:

Menstrual irregularities can manifest as:

  • No menstrual periods (amenorrhea)
  • Frequently missed periods (oligomenorrhea)
  • Very heavy periods
  • Bleeding without ovulation (anovulatory periods)
  • Infertility

Physical symptoms may include:

  • Excess hair growth on the face, chest, belly, or upper thighs (hirsutism)
  • Severe, late-onset, or persistent acne resistant to typical treatments
  • Obesity, weight gain, or difficulty losing weight, particularly around the waist
  • Oily skin
  • Patches of thickened, dark, velvety skin (acanthosis nigricans)


Not all women with PCOS will experience these symptoms; some may experience additional symptoms not listed here. If you are experiencing any of these symptoms, you must talk to your doctor to determine if PCOS may be the cause.

What Tests are Used to Diagnose PCOS?

PCOS diagnosis involves a series of tests to determine the presence of the condition. These tests evaluate:

  • Hormone levels
  • Examine the ovaries for cysts and follicle count
  • Perform other imaging and physical exams

Some common tests include:

Blood Tests

Blood tests are one of the first and most crucial examinations to determine if a woman has PCOS. These tests assess varying hormone levels, such as:

  • Androgens
  • Follicle-stimulating hormone (FSH)
  • Progesterone
  • Testosterone
  • Prolactin

Hormone level analysis helps identify hormonal imbalances, a hallmark of PCOS. High levels of androgens are a common symptom of PCOS.


Pelvic ultrasound is another common diagnostic test for PCOS. This test produces an image of the ovaries, which helps identify cysts and follicles' presence.

During the ultrasound, the doctor briefly places an ultrasound device in the vagina to produce an image of what the ovaries look like. The doctor can also measure the ovaries' size and the endometrial lining's thickness.

Pelvic Exams

A pelvic exam is a physical exam of your reproductive organs. Your provider will check your vagina, cervix, uterus, ovaries, and fallopian tubes for any masses, growths, or other changes.

What are the Risks of PCOS?

Extensive research has shown its widespread prevalence, making it a significant health concern among women.

The risks associated with PCOS are diverse and may include:


One of the most significant risks of PCOS is infertility. Women with PCOS often have difficulty getting pregnant due to irregular or lack of ovulation. Polycystic ovaries can also lead to hormonal imbalances that affect fertility. Women who are struggling with infertility should consider getting tested for PCOS.

Endometrial Cancer

Women with PCOS have a higher risk of developing endometrial cancer. This is because they have irregular periods, which can cause the uterus lining to build up and become thicker.

This thickening can lead to abnormal cell growth, resulting in cancer. As such, women with PCOS need regular check-ups with their gynecologiststo monitor their risk for endometrial cancer.

By doing so, they can catch any potential issues early on and take steps to manage their risk.


PCOS is also associated with an increased risk of developing type 2 diabetes. Women with PCOS often have insulin resistance, which means their bodies have trouble using insulin effectively. Over time, this can lead to high blood sugar levels and, eventually, diabetes.

Women with PCOS should monitor their blood sugar levels regularly and make lifestyle changes to prevent diabetes.

Cardiovascular Disease

Women with PCOS are also at a higher risk of developing cardiovascular disease. This is because the hormonal imbalances associated with PCOS can lead to high blood pressure, high cholesterol, and other risk factors for heart disease. Women with PCOS should make lifestyle changes to reduce their risk of heart disease, such as:

  • Eating a healthy diet
  • Exercising regularly
  • Quitting smoking

Obstructive Sleep Apnea

Obstructive sleep apnea is when a person's breathing is interrupted during sleep. Women with PCOS are at a higher risk of developing obstructive sleep apnea, leading to daytime fatigue,headaches, and other health problems. Women with PCOS should talk to their doctor if they are experiencing symptoms of obstructive sleep apnea.

How is PCOS Treated?

Treatment for PCOS is tailored to the individual's specific symptoms, medical history, and future fertility goals. Treatment aims to manage symptoms and prevent complications such as infertility, type 2 diabetes, and heart disease.

Treatment options include lifestyle changes, medications, and surgery.

Lifestyle Changes

Lifestyle changes are often the first line of treatment for PCOS. These changes can include:

  • Weight loss: Losing weight can help regulate menstrual cycles, improve insulinsensitivity, and reduce androgen levels. It can also decrease symptoms such as hirsutism, acne, and irregular periods.
  • Healthy diet: Eating a balanced diet low in processed foods and high in fiber, fruits, and vegetables can help manage symptoms. Processed foods are often high in calories, sugar, and unhealthy fats, which can exacerbate symptoms. Instead, it is best to focus on nutrient-dense whole foods and provide the body with the vitamins and minerals it needs to function properly. Incorporating more fruits and vegetables into the diet can also help to boost the immune system and reduce inflammation, which can be particularly helpful for those with chronic conditions.
  • Exercise: Regular exercise can help lose weight, improve insulin sensitivity, and reduce androgen levels.


Medications may be prescribed to manage specific symptoms of PCOS. These medications include:

  • Birth control: Oral contraceptives can regulate menstrual cycles and reduce androgen levels. They work by preventing ovulation, which is the release of an egg from the ovary. In addition to preventing pregnancy, oral contraceptives can be prescribed to treat conditions such as PCOS, endometriosis, and acne. These pills are typically taken daily, simultaneously daily, and can be an effective form of contraception when used correctly.
  • Metformin: This medication is commonly used to treat type 2 diabetes but can also help regulate menstrual cycles and improve insulin sensitivity in women with PCOS. This is because metformin reduces the amount of glucose the liver produces, which helps lower blood sugar levels. In addition, it can also help decrease the levels of androgens in the body, leading to improvements in menstrual regularity and fertility for women with PCOS.
  • Anti-androgen medications: These medications block the effects of androgens and can help reduce hirsutism (excessive hair growth) and acne.


Surgery may be recommended for women with PCOS who have not responded to other treatments and are experiencing severe symptoms. The most common surgical procedures for PCOS include:

  • Ovarian drilling: One of the procedures that can be used to address high androgen levels and enhance fertility is ovarian drilling, which entails using a laser or heat to destroy a small section of the ovary. By doing so, the procedure can reduce androgen levels and improve the chances of successful conception.
  • Ovarian wedge resection: This procedure involves removing a wedge-shaped piece of the ovary to help regulate menstrual cycles and improve fertility.

Health Warning:

While these treatments can effectively manage symptoms, there is currently no cure for PCOS. Regular check-ups with a healthcare provider and ongoing management of symptoms are necessary to prevent complications and maintain overall health.

What Lifestyle Changes Can Help Manage PCOS?

Are you looking for ways to manage PCOS through lifestyle changes? Here are some changes that could be helpful:


A healthy diet is essential in managing PCOS. High-fiber foods and lean protein are recommended while limiting refined carbohydrates and sugary foods.

Some examples of foods to include in the diet are:

  • Fruits and vegetables
  • Whole grains
  • Lean meats
  • Low-fat dairy products
  • Nuts and seeds

It is also important to maintain a healthy weight, as losing even a small amount of weight can help regulate menstrual cycles and improve insulin resistance.


Regular exercise can help improve insulin sensitivity and lower androgen levels. Aiming for at least 30 minutes of moderate-intensity exercise most days of the week is recommended. Some examples of exercises that can be beneficial are:

  • Brisk walking
  • Jogging
  • Cycling
  • Swimming
  • Strength training

Stress management

Stress can worsen PCOS symptoms, so it is important to manage stress levels. Some effective stress management techniques include:

  • Yoga
  • Meditation
  • Deep breathing exercises
  • Regular massages
  • Spending time with loved ones


Getting enough sleep is crucial in managing PCOS symptoms. Aiming for at least 7-8 hours of sleep each night is recommended. Some tips for improving sleep quality include:

  • Establishing a regular sleep schedule
  • Creating a relaxing bedtime routine
  • Avoiding caffeine and alcohol before bedtime
  • Keeping the bedroom cool and dark

Individuals with PCOS can help manage their symptoms and improve their overall health by making these lifestyle changes.

What is the Difference Between PCOS and PCOD?

PCOS and PCOD are similar but distinct conditions affecting the ovaries and causing hormonal imbalances.

What is the Link Between PCOS and Infertility?

PCOS affects the ovaries, causing irregular egg release and the development of small cysts. This contributes to the challenges of getting pregnant. Pregnant women with PCOS face higher risks of complications like gestational diabetes, preeclampsia, and premature birth, requiring close prenatal care.

Healthcare providers use blood tests for hormone levels, ultrasounds to examine ovaries, and glucose tolerance tests for insulin resistance to diagnose PCOS. These tests help determine the best treatment and management to improve pregnancy chances.

How to prepare for your PCOS test appointment?

Preparing for your PCOS test appointment can help ensure that you get accurate and comprehensive results.

If you suspect you have PCOS, your journey may involve consulting with specialists such as:

  • Gynecologists
  • Endocrinologists
  • Reproductive endocrinologists

Before Your Appointment

Here's what you can do to prepare for your appointment:

1. Compile Symptom Details: Create a list of the symptoms you've been experiencing, noting how long you've had them and their severity.

2. Record Menstrual Information: Document information about your menstrual cycles, including their frequency, duration, and flow.

3. List Medications and Supplements: Make a comprehensive list of all medications, vitamins, herbs, and supplements you are currently taking, along with their dosages.

4. Personal and Medical History: Prepare key personal and medical information, including any recent life changes, stressors, or other health conditions you may have.

5. Prepare Questions: Jot down questions you want to ask your healthcare provider. Sample questions include:

  • What specific tests do you recommend for diagnosing PCOS?
  • How does PCOS impact fertility and the likelihood of getting pregnant?
  • Can lifestyle changes help manage my symptoms?
  • What are the potential long-term effects of PCOS on my health?

During Your Appointment

Your healthcare provider will likely inquire about your symptoms and medical history. Be prepared to answer questions such as:

  • What symptoms have you been experiencing, and how frequently do they occur?
  • On a scale of severity, how would you rate your symptoms?
  • When did you first notice each symptom?
  • When was your last menstrual period?
  • Have you observed any factors that worsen or alleviate your symptoms?
  • Are you actively trying to conceive or planning to do so in the future?
  • Has any close family member, like your mother or sister, been diagnosed with PCOS?

Feel free to ask any additional questions that arise during the appointment. Your healthcare provider is there to address your concerns and provide the information you need to understand better your situation and options for managing PCOS.

The Bottom-line

Women diagnosed with PCOS should be aware of the associated risks, such as infertility, endometrial cancer, diabetes, cardiovascular disease, and sleep apnea. Regular check-ups with healthcare providers are essential to monitor and manage these risks effectively.

In this journey towards better health, education is a powerful tool. With knowledge about PCOS, its tests, and the available treatments, women can confidently navigate their health paths.

Let's promote awareness, support, and proactive health management, ensuring a brighter and healthier future for women worldwide.

FAQs on PCOS Tests

1. How accurate are PCOS tests?

PCOS tests are generally considered accurate, but false positives and negatives can occur. False positives can occur when a woman has symptoms similar to PCOS but does not actually have the condition. False negatives can occur when a woman has PCOS, but the test results do not show it. In some cases, multiple tests may be needed to confirm a diagnosis.

2. What are the risks and side effects associated with PCOS tests?

PCOS tests are generally safe and do not have any significant risks or side effects. Blood tests may cause minor discomfort or bruising at the site where the blood is drawn. Ultrasounds are non-invasive and do not involve any radiation. Physical exams are also non-invasive and do not involve any risks.

3. How much do PCOS tests cost?

The cost of PCOS tests can vary depending on the type of test and where it is performed. Blood tests can cost anywhere from $50 to $200, while ultrasounds can cost between $200 and $1,000. Insurance typically covers physical exams and may not have any out-of-pocket costs.

4. How often do PCOS tests need to be repeated?

PCOS tests do not need to be repeated regularly unless there is a change in symptoms or treatment. Women with PCOS may need regular blood tests to monitor hormone levels and check for complications. Ultrasounds may be repeated if there is a change in symptoms or to monitor the growth of cysts.

5. What are the consequences of not having PCOS tests?

Without PCOS tests, women with PCOS may not receive a proper diagnosis and may not receive appropriate treatment. PCOS can lead to various complications, including infertility, diabetes, and heart disease. Early diagnosis and treatment can help prevent these complications and improve overall health.

6. What are the chances of false positives and false negatives with PCOS tests?

The chances of false positives and negatives with PCOS tests vary depending on the type of test and the individual woman. Blood tests are generally considered accurate, but false positives and negatives can occur. Ultrasounds can also produce false positives and negatives if the cysts are too small to detect. In some cases, multiple tests may be needed to confirm a diagnosis.

7. What are the alternative methods for diagnosing PCOS?

The Rotterdam criteria are an alternative method for diagnosing PCOS that requires the presence of at least two of the following: irregular periods, excess androgen levels, and cysts on the ovaries. Another alternative method is the Androgen Excess and PCOS Society criteria, which require the presence of hyperandrogenism and ovulatory dysfunction.

8. What is the prognosis for women with PCOS?

The prognosis for women with PCOS depends on the severity of their symptoms and the presence of any complications. With proper treatment, many women with PCOS can manage their symptoms and lead healthy lives. However, PCOS can lead to a range of complications, including infertility, diabetes, and heart disease, so women with PCOS need to receive regular medical care and monitoring.