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PCOS Diagnosis Process

Last reviewed: February 16, 2026

Understanding how PCOS is diagnosed, what tests are involved, and what to expect during the diagnostic process.

PCOS Diagnosis Process

Getting an accurate diagnosis of Polycystic Ovary Syndrome (PCOS) involves several steps. Understanding the diagnostic process can help you prepare for your medical appointments and know what to expect.

What It Means

PCOS is typically diagnosed using the Rotterdam criteria, which requires at least two of the following three features:

  1. Irregular or absent periods
  2. Signs of excess androgens (male hormones) - either through symptoms or blood tests
  3. Polycystic ovaries visible on ultrasound

Common Steps in Diagnosis

Medical History

Your healthcare provider will ask about:

  • Your menstrual cycle patterns
  • Symptoms you're experiencing
  • Family history of PCOS, diabetes, or other hormonal conditions
  • Weight changes
  • Fertility concerns (if applicable)

Physical Examination

The examination may include:

  • Checking for signs of excess hair growth (hirsutism)
  • Examining your skin for acne, dark patches, or skin tags
  • Checking your blood pressure
  • Measuring your waist circumference
  • Checking for signs of insulin resistance

Blood Tests

Common blood tests include:

  • Hormone levels: Testosterone, DHEA-S, and other androgens
  • LH and FSH: Luteinizing hormone and follicle-stimulating hormone
  • Glucose and insulin: To check for insulin resistance
  • Lipid panel: To check cholesterol and triglycerides
  • Thyroid function: To rule out thyroid disorders
  • Prolactin: To rule out other conditions

Ultrasound

An ultrasound may be performed to:

  • Check for multiple small cysts on the ovaries
  • Assess ovarian size and appearance
  • Rule out other conditions

What Is Normal

It's normal to feel anxious about medical tests and diagnosis. Remember that:

  • Many symptoms can have other causes
  • Not everyone with some PCOS symptoms has the full condition
  • Diagnosis is a process, not a single test

What Is Not Normal

You should seek a second opinion if:

  • Your symptoms aren't being taken seriously
  • You're not being offered appropriate testing
  • Your diagnosis seems unclear or rushed
  • You feel your concerns aren't being addressed

When to See a Doctor

Consult a healthcare provider if:

  • You have irregular periods or other PCOS symptoms
  • You want to understand your hormonal health
  • You're having difficulty conceiving
  • You want to discuss treatment options

After Diagnosis

Once diagnosed, your healthcare provider will:

  • Discuss treatment options based on your symptoms and goals
  • Address specific concerns (fertility, weight management, symptom control)
  • Create a management plan
  • Schedule follow-up appointments

Treatment Goals

Treatment typically focuses on:

  • Regulating menstrual cycles
  • Managing insulin resistance
  • Addressing specific symptoms (hair growth, acne, etc.)
  • Supporting fertility (if trying to conceive)
  • Reducing long-term health risks

Remember, PCOS is a manageable condition. With proper diagnosis and treatment, you can effectively manage your symptoms and reduce your risk of complications.

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