What a Good PCOS Workup Looks Like (AKA How to Get a PCOS Diagnosis)

Has Polycystic Ovarian Syndrome come up in your discussions with your healthcare provider? Have you struggled with painful menstrual cramping (especially on one side), serious cystic acne or excessive dark hair growth, or irregular periods? While having any one of these doesn’t automatically point to a PCOS diagnosis, altogether they can mean more than an annoying that time of the month.

We’ve talked about what PCOS is and why it makes your period erratic, but oftentimes, the hardest part is getting a diagnosis. That’s why we want to lay out three components of a good PCOS workup—so if you think you might have it, you can talk to your doctor (or, chat with one of our providers, who are skilled at hormonal imbalances and diagnostics).

A Detailed Health History

A good PCOS workup should include a very detailed health history—a head to toe discussion about your health from your birth until now (did you know you were born with all the eggs you’ll ever have?). Topics in this history should touch on antibiotic usage, oral contraception use, food plan, exercise patterns, and your menstrual cycle quality throughout the years. Be prepared for this by writing it all down beforehand, gathering any necessary medical records you might have access to, and talking with your caregivers about your childhood health history.

Lab Testing

The lab testing piece is really important to know what’s going on inside your body. You’ll want a full hormone panel timed correctly during your cycle. Your provider should be able to instruct you when the best day to get it done is based on the frequency of your cycles and your specific symptoms. The timing is crucial, as your hormones fluctuate on a daily (sometimes hourly!) basis.

In addition to a hormone panel, you’ll want a thyroid panel, inflammation markers, blood sugar markers (including a fasting insulin level), adrenal testing (that includes DHEA), cholesterol levels, and nutrient testing. Each of these tells your provider more about what how your body is functioning and if PCOS could be a contributing factor.

There might be others your provider would recommend to you based on your individual case, but these are a great baseline to start with!

An Ultrasound (If Necessary)

If we’re trying to diagnose PCOS, an ultrasound is a good step. It allows us to see endometrial thickness (how thick the layer of your uterus is that you bleed each month), get a view of your ovaries to check for any cysts and get a sense of how your anatomy may play a role in your cycle regularity. An ultrasound doesn’t necessarily rule out PCOS, but having a literal picture of what’s happening in your reproductive system helps.

If all of this sounds overwhelming, take a deep breath. You don’t have to do it alone—we’re here to help. Our providers are trained to look at your whole health picture, to listen to your entire health story, and to create a plan that’s specific to your needs, PCOS or not. Schedule an appointment to get more info.