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Diagnosis

If you think you have polycystic ovary syndrome (PCOS), it’s important you see your doctor. You might be referred to a specialist, such as an endocrinologist (hormone specialist) or gynaecologist for more detailed assessments. An early diagnosis and support from a team of specialists can help manage the symptoms of PCOS and reduce the risk of long-term health problems.

Learn more about how PCOS is diagnosed.

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How is PCOS diagnosed?

If you have PCOS symptoms, see your doctor. Your doctor will review your medical history and assess your physical symptoms, weight and BMI (body mass index). They may also recommend certain tests to rule out other conditions.

PCOS may be diagnosed if you have two or more of the following symptoms:

  • Irregular or no periods.
  • Features of ‘clinical androgen excess’ (e.g. pimples and excess hair growth) or higher than normal androgen levels (shown in your blood test). Androgens are male-type hormones.
  • Polycystic ovaries visible on an ultrasound (i.e. more than 20 partly-developed eggs are visible on your ovaries or your ovaries are enlarged).

You don’t need to have an ultrasound to confirm PCOS if you have irregular or no periods and high androgen levels.

Ultrasounds are not recommended for women under 20 years of age.

Tests

Your doctor may ask you to do different tests before they confirm a PCOS diagnosis. The tests will depend on your individual symptoms.

Blood tests

Blood tests for testosterone and free androgen index (FAI) can identify high androgen levels.

You may also have blood tests to check the levels of other reproductive hormones that affect your periods. For example, oestrogen (the female sex hormone) or the follicle-stimulating hormone (FSH).

Your doctor may also recommend blood tests to exclude conditions with similar symptoms to PCOS.

If you are taking the contraceptive pill, you will need to stop for three months before you do blood tests to check your hormone levels.

Ultrasound

Your doctor or specialist may perform an abdominal ultrasound to check for signs of PCOS (e.g. partly-developed eggs on your ovaries, enlarged ovaries or a thickened uterus lining).

A transvaginal ultrasound may be used on women who are sexually active. This is a procedure where a probe is inserted into your vagina, giving a much clearer picture of your ovaries than an abdominal ultrasound.

Other tests

Your doctor may want to do some tests to assess your risk of developing heart (cardiovascular) disease and type 2 diabetes.

For example:

  • a cholesterol blood test
  • a blood pressure test
  • a glucose tolerance blood test.

If you have PCOS, you will need a cholesterol and diabetes test every few years, and a blood pressure check every year. If you have risk factors, such as a family history of diabetes or previous abnormal cholesterol tests – or if you are planning to get pregnant – you will need to do these tests more often.

PCOS in teenage years

It’s hard to diagnose PCOS in young women in the first few years after their periods start. During this time, periods are often irregular, but they usually settle into a regular pattern by the second year.

If this doesn’t happen and your periods are either very close together or far apart, it may be due to PCOS. If you are bothered by other PCOS symptoms (e.g. excess hair growth or acne) you may be assessed for PCOS. But your doctor might prefer to monitor symptoms as a first step.

This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at May 2023.

This con­tent has been reviewed by a group of med­ical sub­ject mat­ter experts, in accor­dance with Jean Hailes pol­i­cy.

1
Monash University. International evidence-based guideline for the assessment and management of polycystic ovary syndrome. 2018. Melbourne, Australia.
2
McCartney CR, Marshall JC. Clinical practice: polycystic ovary syndrome. N Engl J Med. 2016; 375(1):54–64
3
Goodman NF, Cobin RH, Futterwelt W, Glueck JS, Legro RS, Carmina E et al. American Association of Clinical Endocrinologists, American College of Endocrinology, and Androgen Excess and PCOS Society Disease State Clinical Review: guide to the best practises in the evaluation and treatment of polycystic ovary syndrome – part 1. Endocr Pract. 2015 Nov; 21(11):1291–300.
Last updated: 
05 February 2024
 | 
Last reviewed: 
29 May 2023

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