So you think you may have PCOS, now what? Top Lab Tests you Should Consider for PCOS


Polycystic Ovarian Syndrome (PCOS) is a condition that affects 1 in 10 women in America. It is an endocrine disorder that involves hormone imbalances. Some of the common symptoms of PCOS include weight gain, hair growth, insulin resistance, acne, mood swings, anxiety, etc. Getting a comprehensive lab test is one of the first steps in determining if you have PCOS. We will walk through the top lab tests for PCOS in this article.

PCOS is diagnosed using the Rotterdam criteria where 2 of 3 of the following need to be present:

  • Hyperandrogenism
  • Long menstrual cycles or delayed ovulation
  • Polycystic Ovaries on Ultrasound

Lab Tests you should consider:

  1. Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH)

LH and FSH are hormones secreted from the pituitary gland. These hormones send messages to the ovaries to release estrogen and progesterone. If you have PCOS we will tend to see a high LH:FSH ratio. It can be a 2:1 or even 3:1 ratio on day 3 of your cycle.

  1. Prolactin

Prolactin is also released from the pituitary gland and can be high in patients with PCOS. Therefore, it is important to check out your prolactin levels. A great herb that can correct high levels of prolactin is Vitex angus-castus.

  1. Estrogen and Progesterone

Estrogen and progesterone are key hormones throughout the hormone cycle. Estrogen is dominant in the first half of the cycle. Healthy levels of estrogen ensure proper follicle development. Progesterone is dominant in the second half of the cycle and healthy levels are important to maintain a successful pregnancy. It is important to check your levels of both hormones!

  1. Fasting Glucose and Fasting Insulin

Insulin is an important hormone in the body that works to bring glucose into our cells. Many PCOS patients will have insulin resistance, meaning their cells do not respond as well to insulin. Checking your fasting glucose and insulin is important to determine if you have insulin resistance. Generally I like to see fasting glucose below 5.0 mmol/L and fasting insulin below 50 pmol/L.

  1. DHEA, Free and Total Testosterone

Having higher levels of testosterone is notorious in PCOS patients. There are two sources of testosterone, the first is from the adrenal glands located on top of the kidneys, which is responsible for dealing with stress. About 40-50% of PCOS patients show high levels of DHEA, which is responsible for adrenal androgen levels.

The other source of testosterone is from the ovaries. Testosterone will convert to estrogen through the activity of aromatization. However, in PCOS patients the aromatization is not as effective leading to poor follicle development. Ensuring proper follicle development is important for ovulation.

  1. Thyroid Stimulating Hormone (TSH)

Checking the thyroid is very important to check not only for PCOS patients but anyone trying to conceive. TSH is a hormone secreted from the pituitary gland. It sends a message to the thyroid to release thyroid hormones. Research shows that a TSH level between 1.0 – 2.0 mIU/L is important if you are trying to conceive.

If you think you may have PCOS, talk to your doctor to get a comprehensive lab test to determine what exactly is going on with your hormones!

Looking for more support? Join Your PCOS Planner Here

This article was originally posted at Fertility Matters Canada.


“High DHEA And Testosterone In PCOS | What Is The Difference”. Toronto Naturopath | Women’s Health, Fertility, Thyroid, Autoimmune. N.p., 2014. Web. 28 Aug. 2016.

“New Thyroid Guidelines For Pregnancy ( And Fertility! ) – Toronto Naturopath | Women’s Health, Fertility, Thyroid, Autoimmune”. Toronto Naturopath | Women’s Health, Fertility, Thyroid, Autoimmune. N.p., 2011. Web. 28 Aug. 2016.


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