PCOS Diagnosis
How PCOS is Diagnosed, Methods and Criteria

PCOS Guide to diagnosis


PCOS Diagnosis


How Is PCOS Diagnosed?
Procedural Steps
Why Diagnosis Is Important

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PCOS Guide

How Is PCOS Diagnosed?

As PCOS symptoms are similar to so many other conditions, it is often misdiagnosed. This became more an issue after a study in 2000 discovered that women with PCOS are more at risk of developing coronary heart disease (CHD). In 2003 it was agreed between the European Society of Human Reproduction and Embryology and the American Society of Reproductive Medicine that a PCOS diagnosis should be made when 2 of the following 3 criteria are met:

Criteria 1
Polycystic ovaries are found on ultrasound scan.

Criteria 2
Absence of periods (oligomenorrhea) and failure to release eggs (anovulation) exists.

Criteria 3
Clinical evidence of hyperandrogenism is found (the existence of excessive male hormones). This may present itself clinically as hirsutism, acne, and/or male pattern hair loss (alopecia).

However these standards are not set in stone as some women with PCOS may only meet one of the criteria. Another more practical diagnosis has been proposed: PCOS should be diagnosed where 1 of 4 classic PCOS symptoms exists (combined with a confirmation of polycystic ovaries by ultrasound scan):

• Menstruation irregularities
• Acne
• Hirsutism
• Anovulatory infertility

Procedural Steps

Step 1: Medical Examination

The physician will first want to exclude other conditions which show similar symptoms to PCOS including diabetes, hypothyroidism, chronic anovulation, adrenal abnormalities and pregnancy. To do so, a thorough physical examination will need to take place, including a pelvic exam, a review of symptoms and family medical history.

Step 2: Blood Tests

Diagnostic blood tests will most likely be taken by your doctor. Hormone levels will be tested, usually:

• Testosterone
• Dehydroepiandrosterone (DHEA)
• Luteinizing Hormone (LH)
• Follicle Stimulating Hormone (FSH levels)
• Milk-producing hormone Prolactin

Your doctor may also test for associated conditions like insulin resistance (Glucose tolerance testing (GTT)) and high cholesterol.

Step 3: Transvaginal Ultrasound

A pelvic ultrasound, usually in the form of a transvaginal scan may be helpful in evaluation. But because polycystic ovaries are not specific to PCOS, ultrasound is not routinely ordered for a diagnosis. In fact over 20 percent of 'normal' women have harmless polycystic ovaries and it does not mean that they have PCOS. However with PCOS the numbers of cysts are usually very high which is why infertility exists. Specific criteria have been set in the evaluation process of 12 or more follicle sacs in each ovary measuring between 2 and 9mm. A scan may be ordered based on the results of returned lab tests, the patient's history and symptoms. With a transvaginal scan a technologist inserts a small condom covered probe into the vagina to give the best views of the pelvic area and ovaries. The procedure is painless and lasts about 30 minutes. The patient should empty their bladder just before it begins. More powerful (and expensive!) imaging techniques such as computed tomography (CT scan) and magnetic resonance imaging (MRI) can also be used to detect cysts. They are generally reserved however for where more serious conditions such as ovarian cancer is suspected.

When all the tests are completed a diagnosis should be possible and PCOS treatment can commence.

Why Diagnosis Is Important

Recent studies indicate that women who suffer from polycystic ovary syndrome may be at increased risk of developing cardiovascular disease. One study showed that 37 percent of PCOS patients had extremely high levels of C-reactive protein (CRP), an early indicator of cardiovascular disease. Based on this, it is important that women with PCOS receive a diagnosis so that they can be monitored for cardiovascular risk factors.

A 2010 study by the University of Gothenburg showed that women with PCOS are more likely to have aberrations in their adipose (fat) tissue. This may explain why women with PCOS are more likely to develop type 2 diabetes. In fact, the authors say it may be more significant than the existence of insulin resistance. Women with PCOS do not have abnormally large amounts of adipose fat (fat around the middle abdominal area) but do have large fat cells and altered adipose tissue. The diagnosis of aberrations could make it easier for doctors to predict which women with PCOS are more likely to develop type 2 diabetes.

Useful: Natural Treatment for PCOS
PCOS Diet, Food to avoid/eat and herbal remedies.

  Related Articles on PCOS Diagnosis

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Functional Ovarian Cysts

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