© 2015 by PCOS Pathways

Getting a diagnosis

PCOS can be diagnosed by a discussion with your
Doctor and a series of tests.

If you think you might have PCOS - go to your Doctor. Explain all the symptoms you are experiencing and

ask if they think PCOS could be the cause.

To find out, your Doctor will likely assess you under the Rotterdam Criteria. In western medicine, the Rotterdam Criteria are widely accepted as the best way to diagnose PCOS.


Diagnosis of PCOS under the Rotterdam Criteria is dependent on identifying two of the
following three features:


Oligo/Anovulation. This can be displayed as irregular or infrequent periods that are greater than 35 days apart or less than 21 days apart, indicating that the woman may have had difficulty ovulating, or may not have ovulated at all. Some women have a normal cycle length but still are not ovulating. To test for this, your Doctor will measure your progesterone levels in the luteal phase (after day 21 in a 28 day cycle). If progesterone levels are low in this phase,
it indicates that ovulation has yet to happen - anovulation.


Hyperandrogenism. This means you have increased androgen levels, commonly thought of as male hormones. Hyperandrogenism can present itself physically with increased body and facial hair (Hirsutism), adult acne or severe adolescent acne or a loss of hair on your scalp (Androgenic Alopecia). However, as these physical symptoms aren't always apparent, your Doctor will order a blood test, testing your free testosterone levels.


Polycystic ovaries. This can be shown through the use of ultrasound and is diagnosed when 10 or more small antral follicles are seen in each ovary. The follicles represent eggs that failed to release properly, indicating a difficulty to ovulate.

So, to get a diagnosis of PCOS, your Doctor will need to find at least two of the above testable features of PCOS. If for example, the only feature you're exhibiting is polycystic ovaries, you won't be diagnosed with PCOS, you will be diagnosed as having polycystic ovaries. However, if you are found to have for example, Polycystic Ovaries AND Hyperandrogenism, you will get a diagnosis of PCOS because you are presenting with two symptoms of PCOS, under the Rotterdam Criteria.

There are other tests your Doctor will give you to fill in the larger picture of your PCOS, such as your resistance to insulin and your Lutinising Hormone (LH) : Follicle Stimulating Hormone (FSH) ratio.

To find out about all the different PCOS symptoms, check out the comprehensive
List of PCOS Symptoms page.


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