HOW DO I KNOW IF I HAVE PCOS?

24 Aug 2018

A few weeks ago I posted a blog walking you through the signs, symptoms, and diagnostic criteria of PCOS, or Polycystic Ovarian Syndrome. If you haven’t read it yet, click here to read part one of this PCOS series. 

Here we’re going to run through how to get a proper diagnosis. So if you read through the signs and symptoms and felt like I was describing your life, this one’s for you.

Often times I will have women come into the office in Guelph and when I ask them if they’ve ever been diagnosed with PCOS they will tell me “well, my doctor did an ultrasound and I didn’t have cysts so they said that wasn’t the problem”.

This is a huge myth.

You do not need to have cysts on your ovaries to have PCOS.

Is your mind blown? It is now no longer a requirement for diagnosis to have visible, or even multiple, cysts on ultrasound. This is because PCOS is now considered an endocrine and metabolic disorder vs a physical manifestation.

So what testing do you need to have done in order to figure out if you have PCOS? The following is a brief run down that you can get from either your family doctor or your naturopathic doctor.

Lab Testing for PCOS

LH & FSH

LH and FSH are both pituitary hormones which basically start the hormonal cascade off. FSH helps to build a healthy and mature egg while LH helps to trigger ovulation of that egg. If you are someone who is not having a period or is having really long cycles, it’s worth checking your LH and FSH on day 3 of your cycle to see if this might be keeping you from ovulating. In women with PCOS we might find an LH that is 3-5x higher than FSH when they would be about equal.

Progesterone

When a woman isn’t having a regular period or is having longer cycles, we always want to see where her progesterone is about 7 days after ovulation. This is when progesterone should be at its peak. Often times in PCOS, women are not ovulating at all, which leaves their body deprived on the progesterone that is generated from the ruptured follicle.

Fasting Insulin and Fasting Glucose

PCOS often goes hand in hand with insulin resistance. This happens when your cells are no longer responding to insulin the way that they should be, leaving glucose to float freely around in your blood. It can lead to weight gain and impact ovulation. We want to test both of these in the morning after an overnight fast.

Free Testosterone, Total Testosterone and DHEA

Testosterone and DHEA are androgenic hormones that lead to unwanted hair growth, acne, and impact ovulation when they are high. Testosterone is increased in the ovaries when women are insulin resistant. It’s this extra testosterone that causes the egg to get stuck and form a cyst around ovulation.

All of the above tests are done in the blood. Running a full saliva hormone panel with cortisol can also be extremely beneficial to figure out what’s going on with your hormones, especially if you’re having irregular cycles.

If you’re interested in learning more about testing, contact Dr. Kelsey Duncan, Naturopathic Doctor in Guelph ON to get started!

Image: Photo by Victoria Heath on Unsplash