Unfortunately, there is no single, conclusive test for diagnosing PCOS and it is unknown what causes it. Rather, a doctor makes the diagnosis after completing many tests and seeing the manifestation of several symptoms. Although this can lead to frustration, remember that the most important things is not to find a name for you problem, but rather a solution that makes you feel better. The following are tests/exams your doctor may perform and they will provide the parameters on which he will base his diagnosis:
- Medical history. Your doctor will ask about the medical history of you and your family. This may include information about your menstrual cycles, weight changes, and more.
- Physical exam. Your doctor will want to do a standard physical exam which will include such tests as blood pressure, body mass index (BMI (check yours here), and waist size. In addition to this, the doctor will most likely perform a pelvic exam to check if your ovaries are enlarged or swollen by the increased number of small cysts.
- Vaginal Ultrasound (Sonogram). Depending on the conclusiveness of your other tests, your doctor may want to perform a Sonogram (a trans-vaginal ultrasound). This is used to examine your ovaries for cysts (both number and size) as well as the check the endometrium (the lining of your uterus). This lining may thicken over time if you are not having a period which can exacerbate other problems.
- Hormone Panel. The presence of PCOS often correlates with abnormal hormone levels. This includes higher than normal testosterone levels. High testosterone can manifest itself in many qualities that are typically associated with male physicality such as acne, excess hair growth, thinning hair, and more. Your doctor may also recommend a LH/FSH ratio test. Leutinizing Hormone and Follicle Stimulating Hormone are hormones that help regulate your normal cycle. If this ratio is out of balance, PCOS becomes far more likely.
- Elevated Blood Sugar. One of the defining characteristics of PCOS is known as Insulin Resistance. This is what is responsible for excess weight gain, as it makes it difficult for your body to process sugars. Having Insulin Resistance means that there is an elevated amount of insulin in the body as a result of your cells not responding well to circulating insulin. This elevated insulin "attacks" your ovaries and causes them to increase testosterone production as a defense. Insulin Resistance is also an indicator for pre-diabetes. Without management of the condition, 50% of women with PCOS will develop diabetes by the age of 40.
While these tests and criteria are not definitive, they provide a very good place to start. To compound the trickiness of this situation, there is also a subset of women with PCOS who have totally normal results to these tests, even though they may suffer from the condition. This is particularly true is they are on birth control. However, whether you have received a diagnosis or not, discuss with your doctor how to treat the symptoms which you do have. Not treating PCOS can lead to a decreased quality of life now, and serious health problems in the future. The most effective thing you can do at this point is to adopt a strategic lifestyle which is aimed at controlling your PCOS.