PCOS is difficult to diagnose because no test or combination of tests offer a definitive diagnosis. However, PCOS patients usually have elevated androgens (male hormones) and cysts can often be observed on the ovaries. There is a strong association between PCOS and insulin resistance with at least 80% of women with PCOS being insulin resistant.
Different patients experience different manifestations of the syndrome, which complicates both diagnosis and treatment.
Several blood tests and exams will be conducted in order to establish if the patient has any of the following symptoms:
- Elevated free testosterone
- Elevated dehydroepiandrosterone Sulfate (DHEAS)
- Low sex hormone binding globulin (SHBG)
- Insulin resistance, measured by the 2-hour glucose tolerance test
- Elevated luteinizing hormone (LH) when compared to follicle stimulating hormone (FSH)
- Ovarian cysts as seen on an ultrasound (not everyone with PCOS has ovarian cysts and not everyone with ovarian cysts has PCOS)
- Abnormal cholesterol and/or triglycerides
- Elevated liver enzymes, which can indicate non-alcoholic fatty liver disease
At Lisanne Wellness Center we offer nutritional cleanse programs to resolve fatty liver and restore normal liver enzymes in one month.
Women with PCOS usually present with enlarged ovaries with numerous enlarged peripheral cystic follicles and increased central stroma (the middle section of the ovary, which produces androgens). Many studies suggest that the polycystic appearance is due to increased production of androgens, which leads to a lack of ovulation, resulting in the follicle atresia (arrested development).
“Syndrome X” is a new term, which denotes a combination of insulin resistance or diabetes, dyslipidemia, hypertension, and central obesity. While insulin resistance and type II diabetes are frequently associated with obesity, there are women of normal weight who are afflicted as well. Syndrome X may be associated with PCOS.
In 1990 the National Institute of Health established the following criteria for polycystic ovary syndrome (PCOS) diagnosis:
- Elevated testosterone (hyperandrogenism and/or hyperandrogenemia)
- Lack of ovulation (oligoovulation)
- Exclusion of other known disorders
- In 2003, PCOS was defined as having at least two of the following three conditions: Show this image
- Lack of ovulation or less than eight cycles per year
- Elevation of testosterone levels in the blood or clinical evidence of increased male hormones
- Polycystic ovaries: enlarged ovaries with 12 or more small follicles