PCOS symptoms blood test explained

Overview

PCOS (polycystic ovary syndrome) is a common hormone condition that affects how a woman's ovaries work. It can cause irregular periods, high levels of male hormones, and small fluid-filled sacs (cysts) on the ovaries.

Yes, PCOS is one of the most common hormone conditions in women and people assigned female at birth.

It mainly affects women and people with ovaries during their reproductive years, typically between ages 15 and 44.

Symptoms

Common symptoms

• Irregular or missed periods
• Excess facial or body hair (hirsutism)
• Acne – especially on the face, chest, and upper back
• Thinning hair on the scalp (male-pattern hair loss)
• Weight gain or trouble losing weight
• Difficulty getting pregnant (infertility)

Symptoms in children

• In teenagers, symptoms may include irregular periods from the start, acne, and unwanted hair growth. However, these can also be normal during puberty, so it is important to see a doctor for proper assessment.

Symptoms in older adults

• After menopause, some PCOS symptoms may ease, but women with PCOS still have a higher risk of type 2 diabetes, high blood pressure, and heart disease.

Causes

Main causes

• The exact cause of PCOS is not known, but genetics and insulin resistance play a big role. High insulin levels can cause the ovaries to make too much testosterone.

Risk factors

• Having a family member with PCOS
• Being overweight or having obesity
• Having insulin resistance or type 2 diabetes

When to see a doctor

See a doctor urgently if:

• If you have very heavy bleeding, severe pelvic pain, or sudden severe symptoms.

Book a routine appointment if:

• If you have irregular periods, unwanted hair growth, acne that doesn't improve, or trouble getting pregnant.

Diagnosis

Diagnosis is usually based on having at least two of these three signs: irregular or absent ovulation, signs of high androgens (either on a blood test or from symptoms like excess hair), and polycystic ovaries seen on an ultrasound scan. Blood tests help measure hormone levels and rule out other conditions.

Tests that may be done

• Blood tests to measure hormone levels (testosterone, LH, FSH, and sometimes SHBG)
• Blood tests for glucose and insulin (to check for insulin resistance)
• Blood tests for cholesterol and triglycerides
• Pelvic ultrasound scan to look at the ovaries

What to expect at your appointment

Your doctor will ask about your symptoms and medical history. You may have a pelvic ultrasound (similar to a pregnancy scan) and blood tests. It may take a few appointments to confirm the diagnosis.

Treatment

Treatment for PCOS focuses on managing symptoms and reducing long-term health risks. It often includes healthy lifestyle changes, medications to regulate hormones or improve insulin resistance, and fertility treatment if needed.

Self-care at home

• Eat a balanced diet with plenty of vegetables, whole grains, and lean protein
• Do regular physical activity (at least 150 minutes of moderate activity per week)
• Maintain a healthy weight – even losing 5% of your body weight can help symptoms
• Manage stress through relaxation techniques or talking to a counsellor

Medical treatments

Medications may be prescribed to help with different symptoms: hormonal contraceptives to regulate periods and reduce acne, medicines that block androgens (male hormones) for hair growth, and medicines that improve how your body uses insulin (like metformin). If you are trying to get pregnant, your doctor may recommend fertility medications. Always discuss options with your healthcare provider – they will advise based on your individual needs.

When is surgery considered?

In some cases, a keyhole surgery called ovarian drilling may be used to help with ovulation if other treatments have not worked. This is not common and is only recommended for specific situations.

Living with this condition

Living with PCOS means working with your healthcare team to manage symptoms and check for long-term health issues like diabetes and heart disease. Regular check-ups, blood tests, and a healthy lifestyle are important.

Lifestyle tips

• Keep up with a healthy diet and regular exercise
• Monitor your blood sugar and cholesterol as advised by your doctor
• Check your blood pressure regularly
• Look after your mental health – talk to your doctor if you feel anxious or depressed

Diet and exercise

A diet rich in whole grains, lean protein, fruits, vegetables, and healthy fats can help control insulin levels. Avoid sugary drinks and refined carbohydrates. Aim for at least 30 minutes of moderate activity most days, like brisk walking, swimming, or cycling.

Mental health and emotional wellbeing

PCOS can affect self-esteem, body image, and mood. Women with PCOS are more likely to experience anxiety and depression. It is important to speak to a healthcare provider if you are struggling emotionally.

Prevention

PCOS cannot be prevented, but early diagnosis and healthy lifestyle changes can help manage symptoms and reduce the risk of complications like diabetes and heart disease.

Complications

If left untreated

• Type 2 diabetes
• High blood pressure and high cholesterol
• Sleep apnea (pauses in breathing during sleep)
• Endometrial cancer (cancer of the womb lining) due to not having regular periods
• Infertility
• Pregnancy complications like gestational diabetes and pre-eclampsia

Long-term outlook

With proper treatment and lifestyle changes, most women with PCOS can manage their symptoms and lower the risk of long-term health problems. Many women with PCOS are able to get pregnant with medical help. You can live a full, healthy life with PCOS.

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