Polycystic Ovarian Syndrome (PCOS) is a condition that affects 1 in 10 women in America. It is an endocrine disorder that involves hormone imbalances. Some of the common symptoms of PCOS include weight gain, hair growth, insulin resistance, acne, mood swings, anxiety, etc. Getting a comprehensive lab test is one of the first steps in determining if you have PCOS.
PCOS is diagnosed using the Rotterdam criteria where 2 of the following 3 need to be present:
- Long menstrual cycles or delayed ovulation
- Polycystic Ovaries on Ultrasound
Lab Tests you should consider:
1. Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH)
LH and FSH are hormones secreted from the pituitary gland. These hormones send messages to the ovaries to release estrogen and progesterone. If you have PCOS we will tend to see a high LH:FSH ratio. It can be a 2:1 or even 3:1 ratio on day 3 of your cycle.
Prolactin is also released from the pituitary gland and can be high in patients with PCOS. Therefore, it is important to check your levels. A great herb that can help correct high levels of prolactin is Vitex angus-castus.
3. Estrogen and Progesterone
Estrogen and progesterone are key hormones throughout the hormone cycle. Estrogen is dominant in the first half of the cycle. Healthy levels of estrogen ensure proper follicle development. Progesterone is dominant in the second half of the cycle and healthy levels are important to maintain a successful pregnancy. It is important to check your levels of both hormones!
4. Fasting Glucose and Fasting Insulin
Insulin is an important hormone in the body that works to bring glucose into our cells. Many PCOS patients will have insulin resistance, meaning their cells do not respond as well to insulin. Checking your fasting glucose and insulin is important to determine if you have insulin resistance. Generally fasting glucose should be below 5.0 mmol/L and fasting insulin below 50 pmol/L.
5. DHEA and Testosterone
Having higher levels of testosterone is notorious in PCOS patients. There are two sources of testosterone, the first is from the adrenal glands located on top of the kidneys, which is responsible for dealing with stress. About 40-50% of PCOS patients show high levels of DHEA, which is responsible for adrenal androgen levels.
The other source of testosterone is from the ovaries. Testosterone will convert to estrogen through the activity of aromatization. However, in PCOS patients the aromatization is not as effective leading to poor follicle development. Ensuring proper follicle development is important for ovulation.
6. Thyroid Stimulating Hormone (TSH)
Checking the thyroid is very important not only for PCOS patients but anyone trying to conceive. TSH is a hormone secreted from the pituitary gland. It sends a message to the thyroid to release thyroid hormones. Ideally a TSH level between 1.0 – 2.0 mIU/L is important if you are trying to conceive.
If you think you may have PCOS, talk to your doctor to get a comprehensive lab test to determine what exactly is going on with your hormones!
“High DHEA And Testosterone In PCOS | What Is The Difference”. Toronto Naturopath | Women’s Health, Fertility, Thyroid, Autoimmune. N.p., 2014. Web. 28 Aug. 2016.
“New Thyroid Guidelines For Pregnancy ( And Fertility! ) – Toronto Naturopath | Women’s Health, Fertility, Thyroid, Autoimmune”. Toronto Naturopath | Women’s Health, Fertility, Thyroid, Autoimmune. N.p., 2011. Web. 28 Aug. 2016.
Samina Mitha is a graduate of the Canadian College of Naturopathic Medicine. You can find her online at www.saminamitha.com.