Lab Tests for PCOS

September is PCOS Awareness Month and I thought this month’s blog posts should be all about PCOS.

PCOS (polycystic ovarian/ovary syndrome) is a common condition globally. Its diagnosis was missed quite frequently (as was in my case), but things seem to be improving in Canada in that regard.

According to the Rotterdam diagnostic criteria for PCOS, you have to have 2 out of 3 of:

  • irregular or anovulatory menstrual cycles
  •  polycystic ovaries on ultrasound (not the same as an ovarian cyst)
  •  manifestations of androgen excess or high levels of androgen(s) on bloodwork

And these symptoms should not be arising from another health condition like adrenal hyperplasia or hyperprolactinaemia etc.


Blue gloved hand with a test tube full of blood in the foreground beside a tray of 4 blood-filled test tubes
Doctor in white coat with stethoscope in ears (and on a patient's arm) looking at blood pressure reading

Testing for PCOS and ongoing testing for PCOS should include:

  • a thorough intake and assessment of your symptoms and experience
  • ultrasound to check for polycystic ovaries
  • physical exam
  • bloodwork that can include CBC, ferritin, B12, vitamin D, a full thyroid panel, cholesterol panel, CRP, fasting glucose + fasting insulin, LH, FSH, testosterone, DHEA-s, prolactin, post-ovulatory progesterone. You’re most welcome to download my PCOS Lab Checklist here.
    • it’s important to note that most of these bloodwork parameters are not diagnostic — the only ones that contributes to the diagnostic criteria are testotsterone and DHEA-s. That being said, the other parameters inform us of how to support you, what co-morbidities exist, how your PCOS is impacting the rest of you, and more.
    • not all bloodwork needs to be run depending on your case and goals
    • repeat bloodwork might look different than your baseline bloodwork depending on frequency of testing, what will provide us with info to measure progress, the timelines for expecting change, etc.

Talk to your doctor about comprehensive testing. And feel free to reach out if you’re in Ontario and looking for PCOS support.