Polycystic Ovary Syndrome short profile

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PCOS

13 tests included

1 working day

Blood

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Polycystic ovarian syndrome (PCOS) is a common condition, affecting up to a quarter of women of childbearing age. The disorder is one of the most common hormonal abnormalities in women of reproductive age and is a leading cause of infertility. Although the underlying cause is not well understood, PCOS is generally characterised by an excess production of androgens (male hormones - usual testosterone), lack of ovulation i.e. anovulation (the egg is not released by the ovary) and absence of menstrual periods (amenorrhoea), and by a varying degree of insulin resistance. The ovaries usually have many fluid-filled sacs (cysts) hence the name of the condition.


This profile measures the amount of the minimum number of hormones in the blood related with PCOS including Free Androgen Index – is a ratio used to determine abnormal androgen status in humans.

About

Androgens are normally created in small amounts by a woman's ovaries and adrenal glands. Even a slight overproduction can lead to symptoms such as hirsutism and acne. In extreme cases, they can lead to virilization.


There is frequently increased secretion of luteinising hormone (LH) from the pituitary gland and all these hormone imbalances affect the menstrual cycle in PCOS, causing infertility problems. Most women with this condition do not have regular periods. Often they have chronic anovulation and amenorrhoea, but they may also experience irregular periods and uterine bleeding. With PCOS, both ovaries tend to be enlarged as much as 3 times their normal size. In many women with PCOS, an ultrasound of the ovaries will reveal cysts (small immature egg-bearing follicles, fluid-filled follicles) that can be seen on the surface of the ovary. When the egg is not released and a woman is not menstruating, sufficient progesterone is not produced. This leads to a hormonal imbalance in which oestrogen acts "unopposed." This can lead to an overgrowth of the lining of the uterus (endometrial hyperplasia) and increases a woman's risk of developing endometrial cancer. Women with PCOS who do ovulate and become pregnant tend to have an increased risk of complications including gestational diabetes, premature delivery, caesarean delivery and miscarriage.


Although the cause of PCOS is not well understood, some think that insulin resistance may be a key factor. Insulin is vital for the transportation and storage of glucose at the cellular level; it helps regulate blood glucose levels and has a role in carbohydrate and lipid metabolism. When there is resistance to insulin's use at the cellular level, the body tries to compensate by making more. This leads to hyperinsulinemia (elevated levels of insulin in the blood). Some believe that hyperinsulinemia may be at least one cause for increased production of androgens by the ovaries.


Most women with PCOS have varying degrees of insulin resistance, obesity, and lipid dysfunction. Insulin resistance tends to be more pronounced in those who are obese and do not ovulate. These conditions put those with PCOS at a higher risk of developing type 2 diabetes and cardiovascular disease.

Preparation

None; however, the sample should be collected 3 to 4 hours after waking. The timing of a woman’s sample will be correlated with her menstrual cycle or, if pregnant, with the gestational age of the baby.

Indications

PCOS is said to be heterogeneous; that is, patients may experience a wide variety of different symptoms to a greater or lesser degree, and vary over time. Also, a uniform and precise definition of the syndrome is lacking. Women often go to their doctor because they are having menstrual irregularities, experiencing infertility, and/or are having symptoms associated with androgen excess. They may experience:
  • Abnormal uterine bleeding
  • Acanthosis nigricans
  • Acne
  • Amenorrhoea or irregular periods (oligomenorrhoea)
  • Decreased breast size
  • Deeper voice (rare)
  • Enlarged ovaries
  • Hirsutism involving male hair growth patterns such as hair on the face, sideburn area, chin, upper lip, lower abdominal midline, chest, areola, lower back, buttock, and inner thigh
  • Weight gain/truncal obesity; fat distribution in the centre of the body
  • Skin tags in the armpits or neck
  • Thinning hair, with male pattern baldness

Interpretation

Your doctor will use the combination of laboratory results and clinical findings to make a diagnosis. If the diagnosis is PCOS your doctor may then request further tests such as lipid profiles and glucose levels to monitor your risk of developing future complications such as diabetes and cardiovascular disease.


A healthcare practitioner who is monitoring hormones will be looking at trends in the levels, rising or lowering over time in conjunction with the age, nutrition and treatment taking rather than evaluating single values. Test results are not diagnostic of a specific condition but give the healthcare practitioner information about the potential cause of a person’s symptoms or status.


See the pages on the individual tests for more detailed information about each one.

Disclaimer

The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario. Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider of the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

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