The medical history includes questions about your symptoms. Your doctor may ask you about changes in your weight, skin, hair, and menstrual cycle. He or she may also ask you about problems with getting pregnant, medicines you are taking, and your eating and exercise habits.
You will also talk about any family history of hormone problems, including diabetes.
The physical exam checks your thyroid gland, skin, hair, breasts, and belly. You will have a blood pressure check and a pelvic exam to find out if you have enlarged or abnormal ovaries. Your doctor can also check your body mass index (BMI).
You may have a pelvic ultrasound, which might show enlarged ovaries with small cysts. These are signs of PCOS. But many women with PCOS don't have these signs.
You may have blood tests to check for:
- Human chorionic gonadotropin (hCG), to find out if you are pregnant.
- Testosterone, an androgen. Androgens at high levels can block ovulation and cause acne, male-type hair growth on the face and body, and hair loss from the scalp.
- Prolactin, which can play a part in a lack of menstrual cycles or infertility.
- Cholesterol and triglycerides, which can be at unhealthy levels with PCOS.
- Thyroid-stimulating hormone (TSH) to check for an overactive or underactive thyroid.
- Adrenal gland hormones, such as DHEA-S or 17-hydroxyprogesterone. An adrenal problem can cause symptoms much like PCOS.
- Glucose tolerance and insulin levels, which can show insulin resistance.
Testing for problems from PCOS
Diabetes. If you have PCOS, experts recommend that you have blood glucose testing for diabetes by age 30.3 You may have this done at a younger age if you have PCOS and other risk factors for diabetes (such as obesity, lack of exercise, a family history of diabetes, or gestational diabetes during a past pregnancy). After this, your doctor will tell you how often to have testing for diabetes.
Heart disease. Your doctor will regularly check your cholesterol and triglycerides, blood pressure, and weight. This is because PCOS is linked to higher risks of high blood pressure, weight gain, high cholesterol, heart disease, hardening of the arteries (atherosclerosis), heart attack, and stroke.
Uterine (endometrial) cancer. Regular menstrual cycles normally build up and "clear off" the uterine lining every month. When the uterine lining builds up for a long time, precancer of the uterine lining (endometrial hyperplasia) can grow. If you have had infrequent menstrual periods for at least 1 year, your doctor may use a transvaginal ultrasound and/or endometrial biopsy to look for signs of precancer or cancer.4