PCOS: How hormone tests can help with diagnosis

One in ten women has polycystic ovary syndrome, or PCOS (yep — it’s that prevalent), but it often goes undiagnosed. Below, we’re digging into what you need to know about PCOS and how a simple hormone test can help you and your doctor find out if you have it.

Table of Contents

What is PCOS?

Polycystic ovary syndrome, or PCOS, is a hormone imbalance that often results in irregular periods or lack of ovulation. Common symptoms of PCOS can include weight gain, insulin resistance, oily skin and/or acne, and hair growth (typically in places like the face, chest, and back).

Most of the time, PCOS is undiagnosed — but it’s very common.

Is there a test for PCOS diagnosis?

Not really. Doctors use something called the Rotterdam criteria (it’s basically a checklist) to diagnose PCOS: 

1) Lack of ovulation or lack of regular ovulation

2) High levels of male sex hormones like testosterone

3) Extra immature follicles in your ovaries

If a doctor is able to check two out of the three boxes, you’ll get a PCOS diagnosis. If you only check a single box, that doesn’t indicate PCOS.

PCOS diagnosis relies on the Rotterdam criteria.

How does a hormone test help inform a PCOS diagnosis?

Modern Fertility tests up to eight hormones — two of which can lead you to a PCOS diagnosis (if discussed with your doctor).

Testing male sex hormones, like testosterone, can clue you in to the possibility of PCOS. That’s because higher levels of testosterone are more prevalent in women with PCOS.

Testing the anti-Mullerian hormone (AMH) can also be helpful. Why? Although not part of the official Rotterdam criteria, detecting high AMH may indicate that the ovaries contain large numbers of immature follicles. (Reminder: A high number of immature follicles is third on the checklist for PCOS.)

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How is AMH related to PCOS?

The cells that surround immature follicles produce AMH. The more immature follicles, the more AMH. Science backs this up: Women with PCOS have higher levels of AMH on average when compared to women who don’t have the condition.

That brings us to the “cyst” in polycystic. The cysts are the immature follicles in the ovaries. When there’s a higher number of these immature follicles (polycystic), they take on the appearance of a “string of pearls” on ultrasounds.

PCOS causes “string of pearls” follicles in the ovaries.
How do you get a formal PCOS diagnosis?

Only a doctor can diagnose PCOS. But if you read the Rotterdam criteria and think that two out of three apply to you, here’s what you can expect if you bring a possible PCOS diagnosis up with your doctor. 

Your doctor will likely ask about how regular your cycle is — and potentially follow up with another blood test to check for a hormone imbalance. 

In some cases, your doctor will suggest a transvaginal ultrasound to take a look at your ovaries.

How might PCOS affect fertility?

The biggest barrier to getting pregnant with PCOS is ovulation. Because PCOS often means the ovaries won’t release an egg every month, there may not always be an egg to fertilize. 

But there are treatments available that help women with PCOS ovulate. There are a few different medications (Clomid, Femara, or hormone injections) and lifestyle changes that might help ovulation resume naturally. 

If those methods don’t end up regulating ovulation, in-vitro fertilization (IVF) can also help women with PCOS get pregnant. 

The bottom line is that there are lots of options — and a doctor can help you plan the best strategy for you.

PCOS can affect ovulation and make getting pregnant more difficult.

What’s the easiest way to test for PCOS?

Just like you can test your cholesterol, you can also test your hormones — and Modern Fertility makes doing that at home easy. Every test comes with customized, physician-reviewed online reports. You also get:

  • A free 1:1 consult with our fertility nurse
  • Online tools to track hormone changes over time and help you plan your timeline for kids
  • Access to our weekly live Q&As
  • An invite to the Modern Community to connect with others and get your questions answered
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Hormone tests can help diagnose PCOS.

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Test your PCOS hormones