Table of ContentsView AllTable of ContentsPregnancy TestFSH/LH17-OHPDHEA/TestosteroneThyroid HormonesSBHGAnti-Mullerian HormoneEstrogenProlactinTests for Related ConditionsTiming
Table of ContentsView All
View All
Table of Contents
Pregnancy Test
FSH/LH
17-OHP
DHEA/Testosterone
Thyroid Hormones
SBHG
Anti-Mullerian Hormone
Estrogen
Prolactin
Tests for Related Conditions
Timing
Blood tests forpolycystic ovary syndrome (PCOS)measure pituitary, adrenal, and thyroid hormones, cholesterol, and blood sugar. These tests rule out other conditions that cause similar symptoms as PCOS.
PCOS blood tests include follicle-stimulating hormone (FSH), progesterone, testosterone, and prolactin. These tests cannot confirm a PCOS diagnosis on their own. An ultrasound showing multiple ovarian cysts is the main diagnostic feature of PCOS.
This article discusses PCOS blood tests. It explains the different hormone levels and what they may mean. It also details other conditions that must be excluded before your healthcare provider can diagnose PCOS.
Westend61 / Getty Images
9 Signs You Could Have PCOS
If you’ve missed your period or have stopped menstruating, the first test your healthcare provider will likely do is apregnancy test.
Like versions that use a urine sample, a pregnancy blood test looks for human chorionic gonadotropin (hCG), a hormone that is only present if you are pregnant.
If the pregnancy test is negative, your provider will move forward with other blood tests.
FSH/LH Blood Test
A diagnosis of PCOS used to be made based on an LH-to-FSH ratio greater than 3-to-1 (3:1), but this is no longer the case. Many people with PCOS have persistently elevated LH levels throughout their menstrual cycles and otherwise normal hormone levels.
If your FSH is elevated, it could also indicate an unrelated condition calledprimary ovarian insufficiency.
17-Hydroxyprogesterone Test
The 17-OHP test is used to determine the presence of late-onsetcongenital adrenal hyperplasia, another medical condition that can mimic the symptoms of PCOS.
DHEA/Testosterone Blood Test
Dehydroepiandrosterone(DHEA)andtestosteroneare hormones calledandrogens. These hormones are responsible for secondary male sex characteristics and are the cause of many of the symptoms of PCOS, including acne,hirsutism(hair growth on the face, chest, and back),female-pattern baldness, andmenstrual irregularities.
An elevation of testosterone is typical in people with PCOS, but it is possible to have a spontaneous outbreak of acne and hirsutism with normal androgen levels and still be diagnosed with PCOS.
Androgen irregularities are a guide to help diagnose PCOS, but they are not a smoking gun.
Other androgens your healthcare provider may test when evaluating PCOS include:
Rarely, abnormally elevated testosterone levels could be a sign of an androgen-secreting tumor of the ovary.Likewise, high DHEA levels could be a sign of an androgen-secreting tumor of theadrenal glands.
Symptoms of High Androgens in Females and How to Treat It
Thyroid Function Tests
A thyroid function panel of blood tests is used to rule out thyroid dysfunction as the cause of your menstrual irregularities.
These two hormones regulate basic metabolic functions. Having low levels of either could cause menstrual changes similar to those experienced in people with PCOS.
Sex Hormone-Binding Globulin (SHBG) Test
Sex hormone-binding globulin (SHBG) is a carrier protein in the blood that transports androgens and estrogen. A low SHBG level is a sign of PCOS.
Low SHBG is also associated with common co-morbidities of PCOS, including:
In addition, alterations in specific genes that regulate SHBG are associated with a higher risk of PCOS.
Anti-Mullerian Hormone (AMH) Test
High levels of anti-Mullerian hormone (AMH) are another sign of PCOS. AMH is released from immature antral follicles in the ovaries, the small fluid-filled cyst-like structures that are a key feature of PCOS.
AMH is believed to inhibit a follicle’s ability to mature into an egg (oocyte). This can prevent ovulation, cause longer menstrual cycles, and lead to infertility.
Estrogen Levels Test
Abnormal estrogen levels are also common with PCOS. Estrogen can be high or low with PCOS, though often estrogen level tests come back normal.
Estrogen is the star hormone of the female reproductive system. Its levels rise and fall throughout the cycle. When estrogen levels are high, it prompts the release of other hormones that stimulate ovulation. If pregnancy does not occur, estrogen levels drop, prompting menstruation.
Estrogen works in tandem with progesterone and other hormones to regulate the menstrual cycle. Both low and high estrogen levels can contribute to longer menstrual cycles, a common symptom of PCOS.
Prolactin Test
If your prolactin levels are elevated, your provider will test your thyroid function because untreated hypothyroidism can also cause elevated prolactin.
Your provider may also want you to have amagnetic resonance imaging (MRI)scan of your pituitary gland to rule out a tumor called aprolactinoma.
How PCOS and Infertility Are Connected
Testing for PCOS-Related Conditions
If you are diagnosed with PCOS, your provider will also screen you fortype 2 diabetesandhigh cholesterol—two conditions that are common in people with PCOS.
Oral Glucose Tolerance Test
Anoral glucose tolerance test (OGTT)measures your response to sugar.Insulinis the major hormone that regulatesblood sugar(glucose) and how it’s metabolized for energy.
For the OGTT, you’ll first have a blood sample taken so that your starting blood sugar level is recorded. Then you will be asked to drink a sugary solution. Blood will be drawn again two hours later to see how well your body is clearing the glucose you ingested.
In people without diabetes, blood sugar levels should return to normal within two hours of drinking the solution. If not, the test can be indicative ofprediabetesordiabetes.
Urine samples are sometimes collected as well.
Lipid Panel
Alipid panelmeasures all of the key values associated with high cholesterol, includingtotal cholesterol,low-density lipoprotein (LDL),high-density lipoprotein (HDL), and another type of lipid calledtriglycerides.
People with PCOS often have high cholesterol, which can increase their risk ofheart diseaseand diabetes.
Some studies suggest that up to 70% of people with PCOS have elevated cholesterol and/or triglycerides.
Could You Cholesterol Test Results Be Wrong?
When Are PCOS Blood Tests Taken?
However, since women with PCOS have irregular menstrual cycles, this can be tricky. Your healthcare provider may wait for you to get your period to start these tests or take them at random times in your cycle.
Hormone testing does not typically require fasting. However, if cholesterol or glucose are being tested at the same time, you may need to stop eating for at least eight hours before the test.
The initial blood draw should only take a few minutes. The amount of time it takes to get PCOS blood test results depends on the lab. Results can be ready within hours but may take a few days if the lab is very busy.
How Is PCOS Treated?
Summary
There is no single test that can diagnose PCOS. Instead, a provider needs to rule out other medical conditions that cause similar symptoms, and blood tests are just one part of this process.
PCOS blood tests measure hormone levels, including 17-OHP, AMH, DHEA, estrogen, FSH, hCG, LH, prolactin, SHBG, testosterone, T3, T4, and TSH,
When a person is diagnosed with PCOS, they also need to be tested for other conditions that are very common in people with the disease, such as diabetes and high cholesterol.
6 Things No One Tells You About Having PCOS
13 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Saadia Z.Follicle stimulating hormone (LH: FSH) ratio in polycystic ovary syndrome (PCOS) - obese vs. non- obese women.Med Arch.2020 Aug;74(4):289–93. doi:10.5455/medarh.2020.74.289-293Raju GA, Chavan R, Deenadayal M, et al.Luteinizing hormone and follicle stimulating hormone synergy: A review of role in controlled ovarian hyper-stimulation.J Hum Reprod Sci. 2013;6(4):227–234. doi:10.4103/0974-1208.126285Macut D, Ilic D, Jovanovic AM, Bjekic-Macut J.Androgen-secreting ovarian tumors.Front Horm Res. 2019;53:100-7. doi:10.1159/000494906Christodoulaki C, Trakakis E, Pergialiotis V, et al.Dehydroepiandrosterone-sulfate, insulin resistance and ovarian volume estimation in patients with polycystic ovarian syndrome.J Family Reprod Health. 2017;11(1):24–29.Ganvir S, Sahasrabuddhe A, Pitale S.Thyroid function tests in polycystic ovarian syndrome.Nat J Physiol Pharm Pharmacol. 2017;7(3):269-72.Xing C, Zhang J, Zhao H, He B.Effect of sex hormone-binding globulin on polycystic ovary syndrome: mechanisms, manifestations, genetics, and treatment.Int J Womens Health. 2022;14:91-105. doi:10.2147/IJWH.S344542Bhide P, Homburg R.Anti-Müllerian hormone and polycystic ovary syndrome.Best Pract Res Clin Obstet Gynaecol. 2016;37:38-45. doi:10.1016/j.bpobgyn.2016.03.004UCSF Health.The menstrual cycle.Xu XL, Deng SL, Lian ZX, Yu K.Estrogen receptors in polycystic ovary syndrome.Cells. 2021;10(2):459. doi:10.3390/cells10020459Szosland K, Pawlowicz P, Lewiński A.Prolactin secretion in polycystic ovary syndrome (PCOS).Neuro Endocrinol Lett. 2015;36(1):53-8Kim JJ, Choi YM.Dyslipidemia in women with polycystic ovarian syndrome.Obstet Gynecol Sci. 2013; 56: 137-42. doi:10.5468/ogs.2013.56.3.137Association for Diagnostics & Laboratory Medicine.Fertility testing.MedlinePlus.Fasting for a blood test.Additional ReadingMayo Clinic.Polycystic ovary syndrome (PCOS).Sirmans SM, Pate KA.Epidemiology, diagnosis, and management of polycystic ovary syndrome.Clinical Epidemiology. 2014;6:1-13. doi:10.2147/CLEP.S37559.
13 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Saadia Z.Follicle stimulating hormone (LH: FSH) ratio in polycystic ovary syndrome (PCOS) - obese vs. non- obese women.Med Arch.2020 Aug;74(4):289–93. doi:10.5455/medarh.2020.74.289-293Raju GA, Chavan R, Deenadayal M, et al.Luteinizing hormone and follicle stimulating hormone synergy: A review of role in controlled ovarian hyper-stimulation.J Hum Reprod Sci. 2013;6(4):227–234. doi:10.4103/0974-1208.126285Macut D, Ilic D, Jovanovic AM, Bjekic-Macut J.Androgen-secreting ovarian tumors.Front Horm Res. 2019;53:100-7. doi:10.1159/000494906Christodoulaki C, Trakakis E, Pergialiotis V, et al.Dehydroepiandrosterone-sulfate, insulin resistance and ovarian volume estimation in patients with polycystic ovarian syndrome.J Family Reprod Health. 2017;11(1):24–29.Ganvir S, Sahasrabuddhe A, Pitale S.Thyroid function tests in polycystic ovarian syndrome.Nat J Physiol Pharm Pharmacol. 2017;7(3):269-72.Xing C, Zhang J, Zhao H, He B.Effect of sex hormone-binding globulin on polycystic ovary syndrome: mechanisms, manifestations, genetics, and treatment.Int J Womens Health. 2022;14:91-105. doi:10.2147/IJWH.S344542Bhide P, Homburg R.Anti-Müllerian hormone and polycystic ovary syndrome.Best Pract Res Clin Obstet Gynaecol. 2016;37:38-45. doi:10.1016/j.bpobgyn.2016.03.004UCSF Health.The menstrual cycle.Xu XL, Deng SL, Lian ZX, Yu K.Estrogen receptors in polycystic ovary syndrome.Cells. 2021;10(2):459. doi:10.3390/cells10020459Szosland K, Pawlowicz P, Lewiński A.Prolactin secretion in polycystic ovary syndrome (PCOS).Neuro Endocrinol Lett. 2015;36(1):53-8Kim JJ, Choi YM.Dyslipidemia in women with polycystic ovarian syndrome.Obstet Gynecol Sci. 2013; 56: 137-42. doi:10.5468/ogs.2013.56.3.137Association for Diagnostics & Laboratory Medicine.Fertility testing.MedlinePlus.Fasting for a blood test.Additional ReadingMayo Clinic.Polycystic ovary syndrome (PCOS).Sirmans SM, Pate KA.Epidemiology, diagnosis, and management of polycystic ovary syndrome.Clinical Epidemiology. 2014;6:1-13. doi:10.2147/CLEP.S37559.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Saadia Z.Follicle stimulating hormone (LH: FSH) ratio in polycystic ovary syndrome (PCOS) - obese vs. non- obese women.Med Arch.2020 Aug;74(4):289–93. doi:10.5455/medarh.2020.74.289-293Raju GA, Chavan R, Deenadayal M, et al.Luteinizing hormone and follicle stimulating hormone synergy: A review of role in controlled ovarian hyper-stimulation.J Hum Reprod Sci. 2013;6(4):227–234. doi:10.4103/0974-1208.126285Macut D, Ilic D, Jovanovic AM, Bjekic-Macut J.Androgen-secreting ovarian tumors.Front Horm Res. 2019;53:100-7. doi:10.1159/000494906Christodoulaki C, Trakakis E, Pergialiotis V, et al.Dehydroepiandrosterone-sulfate, insulin resistance and ovarian volume estimation in patients with polycystic ovarian syndrome.J Family Reprod Health. 2017;11(1):24–29.Ganvir S, Sahasrabuddhe A, Pitale S.Thyroid function tests in polycystic ovarian syndrome.Nat J Physiol Pharm Pharmacol. 2017;7(3):269-72.Xing C, Zhang J, Zhao H, He B.Effect of sex hormone-binding globulin on polycystic ovary syndrome: mechanisms, manifestations, genetics, and treatment.Int J Womens Health. 2022;14:91-105. doi:10.2147/IJWH.S344542Bhide P, Homburg R.Anti-Müllerian hormone and polycystic ovary syndrome.Best Pract Res Clin Obstet Gynaecol. 2016;37:38-45. doi:10.1016/j.bpobgyn.2016.03.004UCSF Health.The menstrual cycle.Xu XL, Deng SL, Lian ZX, Yu K.Estrogen receptors in polycystic ovary syndrome.Cells. 2021;10(2):459. doi:10.3390/cells10020459Szosland K, Pawlowicz P, Lewiński A.Prolactin secretion in polycystic ovary syndrome (PCOS).Neuro Endocrinol Lett. 2015;36(1):53-8Kim JJ, Choi YM.Dyslipidemia in women with polycystic ovarian syndrome.Obstet Gynecol Sci. 2013; 56: 137-42. doi:10.5468/ogs.2013.56.3.137Association for Diagnostics & Laboratory Medicine.Fertility testing.MedlinePlus.Fasting for a blood test.
Saadia Z.Follicle stimulating hormone (LH: FSH) ratio in polycystic ovary syndrome (PCOS) - obese vs. non- obese women.Med Arch.2020 Aug;74(4):289–93. doi:10.5455/medarh.2020.74.289-293
Raju GA, Chavan R, Deenadayal M, et al.Luteinizing hormone and follicle stimulating hormone synergy: A review of role in controlled ovarian hyper-stimulation.J Hum Reprod Sci. 2013;6(4):227–234. doi:10.4103/0974-1208.126285
Macut D, Ilic D, Jovanovic AM, Bjekic-Macut J.Androgen-secreting ovarian tumors.Front Horm Res. 2019;53:100-7. doi:10.1159/000494906
Christodoulaki C, Trakakis E, Pergialiotis V, et al.Dehydroepiandrosterone-sulfate, insulin resistance and ovarian volume estimation in patients with polycystic ovarian syndrome.J Family Reprod Health. 2017;11(1):24–29.
Ganvir S, Sahasrabuddhe A, Pitale S.Thyroid function tests in polycystic ovarian syndrome.Nat J Physiol Pharm Pharmacol. 2017;7(3):269-72.
Xing C, Zhang J, Zhao H, He B.Effect of sex hormone-binding globulin on polycystic ovary syndrome: mechanisms, manifestations, genetics, and treatment.Int J Womens Health. 2022;14:91-105. doi:10.2147/IJWH.S344542
Bhide P, Homburg R.Anti-Müllerian hormone and polycystic ovary syndrome.Best Pract Res Clin Obstet Gynaecol. 2016;37:38-45. doi:10.1016/j.bpobgyn.2016.03.004
UCSF Health.The menstrual cycle.
Xu XL, Deng SL, Lian ZX, Yu K.Estrogen receptors in polycystic ovary syndrome.Cells. 2021;10(2):459. doi:10.3390/cells10020459
Szosland K, Pawlowicz P, Lewiński A.Prolactin secretion in polycystic ovary syndrome (PCOS).Neuro Endocrinol Lett. 2015;36(1):53-8
Kim JJ, Choi YM.Dyslipidemia in women with polycystic ovarian syndrome.Obstet Gynecol Sci. 2013; 56: 137-42. doi:10.5468/ogs.2013.56.3.137
Association for Diagnostics & Laboratory Medicine.Fertility testing.
MedlinePlus.Fasting for a blood test.
Mayo Clinic.Polycystic ovary syndrome (PCOS).Sirmans SM, Pate KA.Epidemiology, diagnosis, and management of polycystic ovary syndrome.Clinical Epidemiology. 2014;6:1-13. doi:10.2147/CLEP.S37559.
Mayo Clinic.Polycystic ovary syndrome (PCOS).
Sirmans SM, Pate KA.Epidemiology, diagnosis, and management of polycystic ovary syndrome.Clinical Epidemiology. 2014;6:1-13. doi:10.2147/CLEP.S37559.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
