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Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder affecting women of reproductive age. It is caused by an imbalance of reproductive hormones which can negatively impact a woman’s body and health. While PCOS symptoms can vary from woman to woman, proper diagnosis plays a crucial role in managing its effects. This article discusses the diagnostic process for PCOS in detail.
Identifying Common Symptoms
The first step towards diagnosis usually begins with recognizing common PCOS symptoms. These include irregular or absent menstrual periods, excess hair growth on face or body, acne, difficulty losing weight, and infertility. However, many women do not experience all symptoms. A healthcare provider examines symptoms to determine if further testing is required.
Conducting Physical Exams
Physical exams help examine symptoms more closely. Doctors check weight, waist circumference, blood pressure and general appearance. Pelvic and thyroid exams check for any abnormalities or cysts in ovaries or thyroid gland. Doctors also look for signs of excess hair growth and acne. Observation of these physical indicators along with symptoms helps ascertain need for further testing.
Ordering Laboratory Tests
If physical exams indicate potential for PCOS, doctors order specific blood tests to confirm diagnosis.
Hormone Level Tests: Tests measure levels of key reproductive hormones- luteinizing hormone (LH), follicle-stimulating hormone (FSH), testosterone, DHEA-S and sex hormone binding globulin (SHBG). Elevated levels of LH and/or testosterone along with decreased SHBG support a PCOS diagnosis.
Thyroid Tests: Tests for thyroid stimulating hormone (TSH) are done to rule out any thyroid issues causing similar symptoms.
Glucose Tests: Oral glucose tolerance tests measure blood glucose levels over time to check for insulin resistance and risk of diabetes. Insulin resistance and prediabetes are common in PCOS.
Additional tests may include liver and kidney function tests, lipid profiles and prolactin levels. Abnormal results from hormone and glucose tests along with symptoms and physical exam findings signify need for more advanced testing.
Conducting Imaging Tests
If initial evaluations indicate PCOS likelihood, transvaginal pelvic ultrasounds help directly visualize ovaries and surrounding structures.
Presence of 12 or more follicles measuring 2-9 mm in diameter or an increased ovarian volume in both ovaries suggests polycystic ovarian morphology. Cysts may measure 2-8mm in size.
While not essential for diagnosis, ultrasounds substantiate physical findings and rule out other potential conditions causing similar presentations including ovarian tumors. Ultrasound findings along with other test results help doctors arrive at a definitive diagnosis.
Finalizing the Diagnosis
To be diagnosed with PCOS, a woman must meet at least two of the following three Rotterdam criteria:
– Irregular menstrual periods or absence of menstruation.
– Clinical/biochemical signs of excess androgens like excess hair growth or acne.
– Polycystic ovaries visualized on pelvic ultrasound.
In absence of clinical signs of excess androgen levels, laboratory tests confirming elevated LH/testosterone levels or anti-Mullerian hormone levels helps. Secondary causes of hyperandrogenism should also be excluded for a PCOS diagnosis.
Meeting the criteria through careful evaluation of symptoms, tests and scans enables an accurate diagnosis. It forms the basis for appropriately managing PCOS through lifestyle modifications and medications depending on individual health factors and goals.
Conclusion
PCOS diagnosis involves a multi-step process of symptom assessment, physical exams, blood and imaging tests to determine if a woman meets diagnostic criteria. Proper diagnosis plays a crucial role in developing an effective long-term management plan tailored to a woman’s health needs and fertility goals. With continued management through lifestyle changes and treatments if needed, PCOS symptoms can often be alleviated.
*Note:
1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it
