Polycystic Ovary Syndrome (PCOS) is a complex hormonal disorder affecting millions of women worldwide. Laboratory tests play a vital role in diagnosing PCOS and excluding other endocrine conditions. A focused hormonal panel helps clinicians evaluate ovarian dysfunction, androgen excess, and insulin resistance.
🧪 Essential Hormonal Tests for PCOS Diagnosis
1. Luteinizing Hormone (LH)
LH levels are often elevated in PCOS, especially relative to FSH. An LH:FSH ratio > 2:1 is suggestive but not diagnostic of PCOS.
2. Follicle-Stimulating Hormone (FSH)
Usually normal or low-normal. Helps rule out ovarian failure if low with low estrogen.
3. Anti-Müllerian Hormone (AMH)
AMH is secreted by small ovarian follicles. Women with PCOS often show elevated levels (>5 ng/mL), reflecting increased follicle count.
4. Total and Free Testosterone
High levels are markers of hyperandrogenism, one of the key diagnostic criteria for PCOS. Free testosterone is more sensitive than total.
5. DHEAS (Dehydroepiandrosterone Sulfate)
Helps assess adrenal androgen contribution. Elevated in 20–30% of PCOS cases.
6. Fasting Insulin and Glucose
Insulin resistance is common in PCOS. Elevated fasting insulin or abnormal HOMA-IR indicates metabolic risk.
📊 Typical Reference Ranges
| Test | Reference Range | In PCOS |
|---|---|---|
| LH | 2–15 IU/L | ↑ (esp. LH:FSH > 2) |
| FSH | 3–10 IU/L | Normal or ↓ |
| AMH | 1–4.5 ng/mL | ↑ (> 5 ng/mL) |
| Total Testosterone | 20–80 ng/dL | ↑ |
| DHEAS | 35–430 µg/dL | ↑ |
| Fasting Insulin | 2–20 µIU/mL | ↑ |
📋 Diagnostic Criteria (Rotterdam 2003)
PCOS diagnosis requires two out of three criteria:
- Oligo- or anovulation
- Clinical or biochemical signs of hyperandrogenism
- Polycystic ovaries on ultrasound
🧾 Additional Tests (if clinically indicated)
- TSH and Prolactin (to rule out thyroid dysfunction and prolactinoma)
- 17-OH Progesterone (to exclude CAH)
- Lipid profile and HbA1c (for metabolic risk assessment)
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❓ Frequently Asked Questions
1. Can PCOS be diagnosed by blood test alone?
No. Diagnosis is clinical plus lab plus ultrasound (Rotterdam criteria).
2. Why is AMH high in PCOS?
PCOS ovaries contain a high number of antral follicles which secrete AMH.
3. What time should these tests be done?
Hormonal tests like LH, FSH, and AMH are best measured on day 2–5 of the menstrual cycle.
✅ Conclusion
The hormonal panel for PCOS includes a combination of pituitary, ovarian, adrenal, and metabolic markers. Interpreting them in context is key for accurate diagnosis and guiding management.
Tags: PCOS, PCOD, Hormonal Panel, LH, FSH, AMH, Testosterone, DHEAS, Insulin, Female Health, Infertility, Lab Tests for PCOS
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