SYMPTOMS & DIAGNOSIS
Symptoms
The symptoms are a manifestation of Insulin resistance and Hyperandogenism or an interplay of the two.
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Diagnosis
The diagnosis of the condition is challenging due to the heterogeneity of the symptoms but is carried out using the Rotterdam criteria. Rotterdam criteria consists of Oligo-Amenorrhoea, Hyperandrogenism and changes in ovarian morphology, presence of any of the two criteria is indicative of PCOS.
Blood Tests
AMH (Anti-Mullerin hormone)
Due to higher number of follicles and due to more production of AMH per follicle PCOS pateints have elevated levels of AMH. AMH level greater than 3.8–5 ng/mL can be used as a diagnostic factor for PCOS.
Hypersecretion of GnRH,FSH,LH
PCOS patients have an LH level of approximately 18 IU/mL and an FSH of 6 IU/mL.
Fasting blood sugar and glucose tolerance tests
High level of insulin indicative of PCOS
Thyroid hormone levels
to make sure thyroid is not contributing to PCOS.
Sex-Hormone Binding Globulin test
Low levels indicative of PCOS
Estrogen
In women with PCOS, high estrogen levels are believed to be caused by the conversion of insulin and testosterone into estradiol, a form of estrogen.
Vitamin B12 and D levels
checked for deficiency.
Prolactin
Levels in women with PCOS can vary between normal to high levels which are more than 25 ng/ml.
Lipid profile
HDL Cholestrol and Triglycerides.High levels of cholesterol can be used as a disgnostic factor.
Dehydroepiandrosterone sulphate (DHEAS);
High levels indicative of PCOS.
17-Hydroxyprogesterone Test:
To rule out Congenital hyperplasia, a condition that mimics some of the symptoms of PCOS.
Ultrasounds
Transvaginal ultrasounds are carried out for detecting ovarian cysts. Presence of at least 12 follicles in each ovary measuring 2–9 mm in diameter, and/or increase in ovary size > 10 ml is indicative of PCOS. (D. Dewailly, 2010)
Pelvic ultrasounds are performed to rule out other reproductive organ related abnormalities.