Diagnosing PCOS

Saschan Fearon  |  23rd Feb 2019

So you’ve discovered you have some of the symptoms of PCOS:

  • Irregular Periods
  • Mood Swings
  • Sleep Apnoea
  • Weight Gain
  • Excess Hair Growth
  • Difficulty getting pregnant

However you’re not sure how to get a diagnosis so what happens next?

If you think you have PCOS or you recognise that you have several symptoms which are common in people with PCOS go and see your GP.

Tell them that you think you might have PCOS

Many doctors still don’t understand PCOS and the symptoms commonly associated with it enough to make the connection that it may be the underlying cause of all the problems you’ve been having. Don’t be afraid to let your doctor know that you’ve done your research and you’d like to explore your options for diagnosis. They’ll ask you about the symptoms you’re having and send you for some blood tests.

Even if you have regular cycles you could STILL have PCOS so if you’re experiencing a combination of the other recognisable symptoms then don’t be put off investigating further.

Blood Tests

Not all doctors will issue the same blood tests to help diagnose PCOS but the most commonly requested tests are:

  • FSH (Follicle Stimulating Hormone)
  • LH (Lutenizing Hormone)
  • Total Testosterone
  • SHBG (Sex Hormone-Binding Globulin)
  • Thyroid Stimulating Hormone
  • Fasting Insulin
  • Glucose Levels

In the UK many doctors will only request LH, FSH and Total Testosterone tests as part of your diagnosis process. It’s best to have these blood tests carried out in the first 2-3 days after your period has started but if you have a very irregular cycle don’t worry as the results will still show if there are raised levels of androgens present. 

We suggest requesting the glucose and fasting insulin tests as there is an increased risk of developing insulin resistance and type 2 diabetes in people with PCOS.


If you’ve ever watched a season of Grey’s Anatomy or any medical drama ever then you’ve probably seen an external ultrasound. When diagnosisg PCOS your doctor ill normally send you for a transvaginal ultrasound where a super lubricated small ultrasound probe is placed just inside the vagina, giving the best views of the ovaries and pelvic area. You don’t need to have a full bladder for this type of ultrasound either which is some consolation right?

If your ovaries are found to have multiple, small cysts around the edge of the ovary that are a few millimetres in size it’s likely you have PCOS however  an ultrasound is not able to diagnose PCOS on its own and should always be supported by blood tests to ensure you’re getting the right diagnosis as not everyone with PCOS has polycystic ovaries.

Remember when you’re undergoing your ultrasound you can ask for someone else to present in the room if you like or you can for a female nurse/ chaperone to be present if the person performing your scan is a man and you’ don’t feel entirely comfortable.

If you’re one of the many people who experiences Vaginismus, believed to be the second most common ‘female’ sexual difficulty in the world, or you fit in the 12-21% of people who experience genito-pelvic pain or you’ve experienced previous sexual trauma then having a trans vaginal ultrasound may be an extremely uncomfortable and difficult experience for you mentally, emotionally and physically. Where you feel comfortable enough to do so we’d always suggest discussing your needs with your sonographer before you get started so that they can provide the best care possible. You don’t have to go into great detail but making them aware that you may need a little more patience, understanding and may ask them to stop can help to make the scan a better experience.