What Tests to Diagnose PCOS? | PYHP 062

PCOS Testing and Diagnosis: In this episode, we talk about the testing and labs for a diagnosis for PCOS. These testing and labs are also a good way to monitor PCOS. Ultrasound: Checking for multiple cysts on or in the ovaries. It is still very common to have PCOS but have not cysts ( string of pearls ). LH: FSH ratio: 2:1 or more DHEA-S: DHEA-sulfate is the best way to test for DHEA levels in the blood.   DHEA-sulfate is a metabolite of DHEA and is much more accurate to determine DHEA levels than a total DHEA level.   DHEA levels are highest when we are young, around 25 years old. And will slowly decline with age. It is considered an androgen. The reference ranges for DHEA-Sulfate are very vast and are based on age. For example, a woman that is 35 years old gets her blood drawn for DHEA-sulfate. The reference ranges for a typical lab is 23-266 mcg/dL.   For a female that has PCOS around 35 years of age, you will see the DHEA-sulfate at 200 or above.  Commonly PCOS, the DHEA-s will show over 200 mcg/dL.   Testosterone: The reference ranges for testosterone labs are huge.   Quest has a reference range of 2-45 ng/dL.   LabCorp has a reference range of 8-48 ng/dL.   Testosterone levels at 35 or higher Estrogen Three circulating estrogens: Estrone, Estradiol, Estriol Vast reference typical reference ranges for most labs: Follicular Phase 19-144pg/mL Mid-Cycle 64-357 Luteal Phase 56-214 Postmenopausal These are large reference ranges and do not tell you a lot. In PCOS the estrogen levels do not fall much and may actually be elevated. Progesterone: It is very common to have low levels of progesterone in PCOS.  Ignore the typical lab reference ranges, which are huge: Follicular Phase<1.0ng/mL   Luteal Phase2.6-21.5ng/mL   Postmenopausal<0.5ng/mL Let’s say you are having regular periods and have your blood work done between days 16-25.  If the less than 1 ng/mL then that woman is not ovulating and we need to work on the progesterone levels. As it is common to have low progesterone in PCOS.    If the progesterone is 4-8 ng/mL, then tha...