Infrequent menstrual period and/or irregular bleeding
Infertility because of not ovulating
Increased growth of hair on
Acne, oily skin, or dandruff
Weight gain or obesity
Type 2 diabetes
High blood pressure
Male-pattern baldness or thinning
Darkened skin on neck, arms,
breasts, or thighs
An individual woman's diagnosis may depend on which specialist she sees and which
investigations are undertaken.
Despite attempts to reach. consensus on the diagnosis of PCOS, it is clear that only a
minority of endocrinologists and gynaecologists adhere to NIH or Rotterdam diagnostic
criteria. According to this study, gynaecologists were less likely to assess glucose
homeostasis but more likely to use a glucose tolerance test to do so.
Diet and exercise
were chosen by most respondents as first-line treatment for all presentations. However,
endocrinologists were more likely to use insulin sensitizers, particularly metformin,
for these indications. In particular, for infertility, endocrinologists favoured
metformin treatment whereas gynaecologists recommended clomiphene.
Conclusions: There is a lack of consensus between endocrinologi-sts and gynaecologists in
the definition, diagnosis and treatment of PCOS. As a consequence, women may receive a
different diagnosis or treatment depending on the type of specialist consulted. (Source:
PCOS: Marked Differences Between Endos and OBGYN'S in Diagnosis and Management)
It is important not to assume that you have PCOS, even if you have several of the symptoms
(ie irregular menstrual cycles, acne, weight problems, hair loss, and/or excess hair). There
may be other health conditions present that are creating problems.
If you think you have PCOS or another health condition, make sure you consult a medical
professional to confirm your suspicions. PCOS diagnosis is made in several ways including medical
history, physical examination, checking hormone levels, and, possibly, an ultrasound.
A health care professional should first take a complete
medical history. He or she will ask questions about your menstrual history, including how old you were
when you started your period, how long your cycles are, how much time passes between cycles, and how
much you bleed in a cycle. Your health care provider will also ask about your reproductive history,
including any pregnancies, miscarriages, or abortions you have had, and birth control methods you are using
or have used in the past. He or she will also ask about menstrual irregularities in other members of
Your practitioner should also do a pelvic and physical exam. Make sure you inform your doctor of any
additional symptoms you may have, including excess hair growth and skin abnormalities such as skin tags
or dark patches on the neck, groin or under arms (which is called acanthosis nigricans). Your height,
weight and blood pressure also will be checked.
A vaginal ultrasound also may be performed to check for multiple follicle cysts in your ovaries. This
test is most commonly performed by fertility specialists and is less commonly done by general
obstetricians and gynecologists. A probe is inserted in the vagina and the picture is shown on a screen
beside the bed. A PCOS diagnosis cannot be made entirely on the basis of the ultrasound alone since not
all women with PCOS have cysts.
This may seem contradictory. Why call it polycystic ovary syndrome when not all women have cysts?
It is because PCOS was identified (originally as Stein-Leventhal Syndrome) many years ago based on
the presence of cysts in the first known patients. Conversely, not all women with cysts have PCOS. The
presence of cystic ovaries does not always mean that you have the syndrome.
If PCOS is suspected, your physician may recommend an extensive check of your endocrine system.
PCOS is to some extent a diagnosis of exclusion. There is not a specific test that can be used to diagnose PCOS and there is not
widespread agreement on what the diagnostic criteria should be.Your doctor will do tests
to rule out other causes of anovulation and infertility. He will usually order a variety
of hormone tests to help determine whether hormone overproduction may be due to PCOS, an
adrenal or ovarian tumor, or an overgrowth in adrenal tissue (adrenal hyperplasia).
Ultrasounds are often used to look for cysts in the ovaries and to see if the internal
structures appear normal.
Your doctor will be looking for a combination of laboratory results and clinical
findings that suggest PCOS. If you are diagnosed with PCOS your doctor may order tests
such as lipid profiles and glucose levels to monitor your risk of developing future
complications such as diabetes and cardiovascular disease. (Source: LabTestsOnline.com)
For a comprehensive chart of 'normal' ranges, and assistance in interpreting fertility bloodwork test results: CLICK HERE!
Write down any questions before the appointment. It is usually faster and more orderly
to have a list, no matter how long it may get. Many questions will be answered in the general course of conversation.
Gather up any appropriate or requested medical records — follow through and make sure the
doctor gets them before the appointment, or bring them. (Sending in advance is generally
preferred.) If the visit is for fertility reasons and one has already done a
hysterosalpingogram (HSG, x-ray test of the uterus and tubes), a copy of the actual film
is preferred to the printed interpretation or report.
Be ready to supply family history, especially about insulin resistance, diabetes, lipid
abnormalities such as high cholesterol, obesity, high blood pressure, heart disease, and
infertility. Include information from both parents and their families. PCOS
characteristics may be passed down from either side of the family.
Familiarize oneself with the symptoms of PCOS and discuss any concerns with the doctor.
If looking for help in getting pregnant, consider bringing in basal body temperature
(BBT) charts to initial evaluation.
See if it would be helpful to arrive for the doctor's appointment in a fasting state,
and clarify any other requirements. (source: Inciid.org.)
Coming soon! Inside PCOS, the first program exclusively for women with Polycystic Ovarian Syndrome. Each week, ask your questions, and hear answers from the top experts in PCOS. Finally..."Radio for me!"