PCOS
Did you know you can have PCOS without having cysts on your ovaries?
This is a conversation that often comes up in my practice.
You can have PCOS with an ultrasound that comes back totally negative with no indication of polycystic ovaries. The cysts that are sometimes present in PCOS are a collection of immature follicles within the ovaries that aren’t undergoing ovulation
Diagnosis
Here is the diagnostic criteria for PCOS (Rotterdam Criteria) - You only have to meet ⅔ of the following:
1️⃣ Irregular periods that are >35 days apart. This means day 1 of your period to day 1 of the next period is more than 35 days.
2️⃣High testosterone on bloodwork OR physical signs of this such as thick hair growth on the face/body, acne, hair loss
3️⃣ Ovarian cysts (more than 12 follicles per ovary) on transvaginal ultrasound
With that said, if you meet the first 2 of the criteria, you technically don’t need to have polycystic ovaries to be diagnosed with PCOS.
Lab Tests / Bloodwork
Lab testing can play an important role when it comes to the diagnosis of PCOS but also ruling out conditions that may look like PCOS. It helps to guide a treatment plan that is specific to you.
It’s not always easy getting a full workup done at your doctor’s office, luckily as a Naturopathic Doctor I can help to fill in these gaps and ensure you’re getting an appropriate workup!
These are some of the tests I tend to run in patients suspected to have PCOS. This isn’t an extensive list and may include more or less depending on your unique presentation.
Here are some highlights of what we’re looking for:
HORMONES (test on day 3 of your period!)
⭐LH - triggers ovulation, often 2-3x/higher than FSH in PCOS, which prevents ovulation and leads to high testosterone
⭐Testosterone - often elevated
⭐Fasting insulin - often elevated in PCOS, which influences testosterone production from the ovaries
⭐CRP - often elevated in PCOS due to chronic low grade inflammation
⭐Vitamin D - often low in PCOS - important for inflammation, regular cycles and acne
Depending on your presentation, we will often run Thyroid tests, Prolactin, Cortisol, Progesterone as well to help in ruling out other conditions.
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