Understanding Lab Tests for Polycystic Ovary Syndrome (PCOS)
Written by Private MD Labs Medical Writing Team • Last Updated: September 8, 2025
Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder affecting women of reproductive age. While there isn't a single definitive blood test to diagnose PCOS, comprehensive hormonal testing is fundamental for identifying the characteristic hormonal imbalances and metabolic changes that define this condition. Blood tests are essential for confirming the diagnosis and monitoring treatment progress.
Top Recommended Test
Testosterone, Free and Total, LC/MS/MS
This comprehensive test measures both free and total testosterone levels, providing a complete picture of androgen excess characteristic of PCOS and helping identify hormonal imbalances and metabolism problems.
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Why Blood Testing is Crucial for PCOS
PCOS involves complex hormonal imbalances affecting reproductive hormones, insulin metabolism, and androgen levels. Blood tests help healthcare providers identify elevated male hormones (androgens), insulin resistance, disrupted ovulation patterns, and other metabolic changes characteristic of PCOS. These tests are vital for distinguishing PCOS from other conditions with similar symptoms.
Other Relevant Tests
Testosterone Total LC/MS/MS
Women with PCOS typically have higher than normal levels of testosterone, a key diagnostic marker. Elevated total testosterone contributes to symptoms like irregular periods, hirsutism, and acne commonly seen in PCOS.
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Testosterone, Free, LC/MS/MS
High levels of free testosterone are a significant indicator of PCOS in women. Free testosterone is the biologically active form that directly contributes to PCOS symptoms and hormonal imbalances.
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Follicle-stimulating Hormone (FSH) and Luteinizing Hormone (LH)
Women with PCOS often show disrupted FSH and LH patterns, with typically elevated LH levels. This imbalance affects ovulation and causes the ovaries to produce excess testosterone, disrupting normal menstrual cycles.
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Anti-Mullerian Hormone (AMH), Female
Women with PCOS tend to have significantly higher AMH levels due to the increased number of small antral follicles in their ovaries. Elevated AMH serves as a reliable indicator and diagnostic marker for PCOS.
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Insulin, Fasting
Insulin resistance is a core feature of PCOS, often leading to elevated fasting insulin levels. This test is crucial for identifying metabolic dysfunction and assessing the risk of developing type 2 diabetes.
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Insulin, Free (Bioactive)
This test measures bioactive insulin levels and helps identify insulin resistance, a common hormonal disorder feature in women with PCOS that contributes to metabolic complications.
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DHEA (Dehydroepiandrosterone), Unconjugated, LC/MS/MS
PCOS is characterized by high androgen levels, which can include elevated DHEA. High DHEA levels indicate excess male hormone production and can help confirm PCOS diagnosis.
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Dehydroepiandrosterone (DHEA-s) Sulfate
Elevated DHEA-S levels may indicate PCOS, as this condition involves overproduction of androgens including DHEA-S. This test helps identify adrenal androgen excess contributing to PCOS symptoms.
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Sex Hormone Binding Globulin, SHBG
Women with PCOS often have lower SHBG levels, which leads to increased free testosterone in the body. Low SHBG contributes to the symptoms and hormonal imbalances associated with PCOS.
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Progesterone
Women with PCOS often have low progesterone levels due to irregular or absent ovulation. This test helps assess ovulatory function and hormonal balance in the reproductive cycle.
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Estradiol
PCOS is often associated with elevated estradiol levels, which contribute to irregular menstrual cycles and other reproductive symptoms characteristic of the condition.
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Estradiol, Ultrasensitive, LC/MS/MS
Women with PCOS often have higher estradiol levels, which can cause irregular periods and fertility issues. This highly sensitive test provides precise measurement of estradiol levels.
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Additional Supportive Tests
Proinsulin
Women with PCOS often have insulin resistance, leading to increased proinsulin production. Elevated proinsulin levels can indicate metabolic dysfunction and help assess insulin-related complications in PCOS.
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Adiponectin(1)
Women with PCOS often have lower adiponectin levels, which may contribute to the insulin resistance commonly seen in this condition and affect metabolic health.
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Leptin, Serum
Women with PCOS often have higher leptin levels, which can contribute to insulin resistance, a key metabolic feature of the syndrome affecting weight management and glucose metabolism.
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Dihydrotestosterone, (DHT) LC/MS/MS
Women with PCOS often have elevated DHT levels, which may contribute to androgenic symptoms like hirsutism (excess hair growth) and acne commonly associated with the condition.
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Prolactin
While not directly causing PCOS, elevated prolactin levels can exacerbate symptoms and complicate the condition by interfering with the ovaries' ability to ovulate normally.
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Understanding Your PCOS Test Results
PCOS diagnosis typically involves identifying at least two of three key criteria: irregular ovulation, elevated androgen levels, and polycystic ovarian appearance on ultrasound. Blood tests are essential for detecting hormonal imbalances and metabolic changes that confirm the diagnosis and guide treatment decisions.
Important Considerations
The information provided here is for educational purposes only and is not a substitute for professional medical advice. PCOS diagnosis and management require comprehensive evaluation by a healthcare provider. Always consult with a qualified healthcare professional for proper diagnosis, interpretation of test results, and treatment planning.
