How is PCOS Diagnosed? A Complete Guide

Understanding the Diagnosis of PCOS

If you’re wondering how to find out whether you have Polycystic Ovary Syndrome (PCOS), you’re not alone. PCOS is a complex condition that can’t be diagnosed with a single test. Instead, diagnosis involves evaluating your symptoms, medical history, and a range of medical tests. A proper diagnosis should always be made by a healthcare professional—typically an OB/GYN or an endocrinologist.

What to Expect at the Doctor’s Visit

When you visit a doctor for a possible PCOS diagnosis, here’s what the process typically involves:

1. A Detailed Medical History

Your doctor will ask about:

Your menstrual cycle: frequency, flow, and date of last period
Symptoms such as unwanted hair growth, acne, weight changes, and skin issues
Pregnancy history and any fertility challenges
Family history, including PCOS, diabetes, or hormonal issues

2. Physical Examination

This may include:

Vital signs: weight, BMI, and blood pressure (you can refuse to be weighed or ask to be blind weighed if this makes you feel uncomfortable)
A skin check for acne, dark patches, or skin tags
Observing hair growth patterns and scalp health
A pelvic exam to assess for any abnormalities

3. Blood Tests

There is no single blood test for PCOS, but your doctor may check:

Androgen levels (e.g., testosterone, DHEA-S)
Gonadotropins (LH and FSH)
Thyroid function (TSH, free T4)
Prolactin levels
Blood sugar and insulin levels
AMH (Anti-Müllerian Hormone), sometimes used as a marker for ovarian reserve

These tests help confirm PCOS and rule out other conditions that can mimic its symptoms.

4. Pelvic Ultrasound

A pelvic ultrasound can identify whether your ovaries appear polycystic (with many small follicles). It can also assess the thickness of the uterine lining. This is just one part of the diagnostic process—some people with PCOS don’t have visible ovarian cysts, and some with cysts don’t have PCOS.

The Rotterdam Criteria for PCOS Diagnosis

Most clinicians use the Rotterdam criteria, which state that PCOS can be diagnosed if you meet two out of these three:

Irregular or absent ovulation (e.g., irregular periods)
Signs of excess androgens (e.g., acne, hirsutism, or high levels on blood tests)
Polycystic ovaries on ultrasound

Other conditions must be ruled out first, such as thyroid disorders or high prolactin levels.

Questions to Ask Your Doctor

When discussing PCOS with your doctor, consider asking:

Could my symptoms be caused by something other than PCOS?
What tests are you ordering and why?
If I have PCOS, what are my treatment options?
What does having PCOS mean for my long-term health?
Should I see any specialists or have regular follow-ups?

Next Steps If You’re Diagnosed

Getting a PCOS diagnosis can feel overwhelming, but it’s the first step toward managing your health. Here’s what you can do:

1. Consult a Specialist

Find someone who specialises in PCOS to ensure you receive personalised advice rather than generic 'just lose weight' advice.

2. Learn About PCOS

Stick to reliable and credible sources to educate yourself and avoid misinformation—social media is rife with self-proclaimed experts. Anyone who has the right qualifications will be able to tell you what they are. Avoid anyone recommending extreme advice or restrictive elimination diets.

3. Focus on Lifestyle Support

Small changes—like a balanced diet, regular physical activity, and stress management—can have a big impact. Big changes can feel overwhelming and be hard to maintain. Think about small things you can do every day to improve your PCOS, such as drinking enough water, adding one extra portion of veg, or doing a few more steps. These might sound small, but together they can be very impactful.

4. Follow Through with Treatment

Your plan might include medications like metformin, hormonal birth control, or fertility treatments—tailored to your specific goals.

5. Monitor Your Long-Term Health

People with PCOS are at higher risk for conditions like type 2 diabetes and heart disease, so regular health check-ups are important.

In Summary

PCOS is a common but complex condition. Diagnosis involves more than just one test—it's about identifying a pattern of symptoms, ruling out other conditions, and often using the Rotterdam criteria. If you suspect you have PCOS, take action by speaking to your doctor, asking the right questions, and seeking out the support you need.

You’re not alone—and with the right knowledge and plan, PCOS is a condition you can manage effectively for the long term.