PCOS test comprehensive

About the PCOS test

PCOS, what is it? In many cases, women with PCOS produce too many male hormones. Ovulation is often very irregular or fails to occur for a long time. It is more difficult for women with PCOS to get pregnant. By gaining insight into AMH, FSH, LH, estrogen, progesterone, testosterone, and prolactin levels, you can determine whether there is a possible disruption in your hormone balance.

About PCOS

PCOS, or Polycystic Ovary Syndrome, is a hormonal disorder affecting women of reproductive age. On average, it affects approximately 1 in 7 women. It is characterized by a disruption of the hormonal balance, which can lead to a number of specific symptoms. The exact cause of PCOS is not yet known, but it is thought that predisposition (genetics) and lifestyle factors play a role.

Common symptoms of PCOS

The symptoms vary from person to person and can be mild or very pronounced and severe. The most common symptoms are:

• No or irregular menstruation
• Difficulty getting pregnant
• Excessive hair growth, particularly on the face, chest, and back
• Unexplained weight gain
• Acne
• thinning hair

We always advise consulting a doctor in case of severe symptoms.

How do you know if you have PCOS

A hormone blood test does not provide a diagnosis. Therefore, a test alone is not sufficient to determine if you have PCOS. A healthcare professional, such as your GP, can determine next steps with you based on abnormal hormone levels. One of these next steps could be, for example, an ultrasound of the ovaries.

What you need to take into account during the assessment

Your hormone levels change throughout your cycle. Ideally, you should collect your sample 3-5 working days before the start of your period. Collect your sample from Monday to Thursday, due to the laboratory closing on weekends. Many women who suspect PCOS have an irregular cycle or miss a cycle. In that case, collect the sample on any Monday to Thursday of your choice. Collect your sample before 10:00 AM when you are fasting; this means not eating for 10 hours and only drinking water. Do not collect your sample immediately after exercising or sexual activity, and ensure you are relaxed. Stress can affect the prolactin hormone, among other things.

The AMH hormone in relation to PCOS

Anti-Müllerian hormone (AMH) is an important hormone for assessing the number of remaining eggs and a woman's fertility. AMH levels decrease as the number of follicles decreases. Women with elevated AMH levels often have a high number of follicles. Normally, 3 to 8 follicles are visible; in PCOS, there are more than 12 per ovary. A very high AMH value is linked to PCOS. A very low AMH value is linked to reduced fertility.

Testosterone and PCOS

One of the most important effects of PCOS is the increase in testosterone in women. In PCOS, the ovaries produce more androgens, such as testosterone, than normal. The increase in testosterone levels can be the result of various factors, such as insulin resistance, elevated LH (luteinizing hormone) levels, and increased stimulation of the ovaries by the LH hormone. This can result in the following symptoms:

• Acne
• Excessive body hair
• Hair loss

If you have one or more of the above symptoms, it may be worthwhile to check whether a high testosterone level is the case.

The LH hormone and PCOS

The LH hormone, also known as luteinizing hormone, causes the ovaries to secrete a substance that triggers ovulation. During ovulation, the LH level in the blood rises. The LH peak occurs just before ovulation and lasts approximately 48 hours. PCOS disrupts the normal hormonal balance, leading to increased LH secretion by the pituitary gland. This causes higher LH levels in the bloodstream, which disrupts ovulation and can lead to symptoms such as irregular menstrual cycles and excessive androgen production (such as testosterone). An elevated LH level also contributes to the formation of ovarian cysts.

The FSH hormone and PCOS

The FSH hormone is important for the production of sex hormones. The FSH hormone is linked to the LH hormone and ensures that eggs can develop in the ovaries. The FSH hormone also stimulates the production of estrogen and progesterone. Women suffering from PCOS often have elevated FSH levels. The FSH hormone is released by the pituitary gland and ensures that ovarian follicles grow and develop. In PCOS, the ovaries generally respond less well to FSH, which can cause follicles not to fully develop and release eggs. A higher FSH value can be an indication that the body is trying to stimulate follicle growth and trigger ovulation. It is important to know that the influence of PCOS on FSH levels is not the same for everyone. There are also women with PCOS who have no elevated FSH or even a reduced FSH level.

Estrogen and Progesterone in relation to PCOS

PCOS (polycystic ovary syndrome) affects estrogen and progesterone, two important female sex hormones. PCOS can lead to elevated estrogen levels due to the excessive production of testosterone, which can be converted into estrogen. This hormonal imbalance can lead to irregular menstrual cycles and other symptoms. Additionally, PCOS can involve irregular or absent ovulation, which can lead to insufficient progesterone production. This can cause anovulation, a condition in which the ovaries do not release an egg. Furthermore, it can cause irregular shedding of the uterine lining, potentially resulting in heavy or prolonged periods. It is also true for estrogen and progesterone that the situation is not the same for every woman with PCOS.

Prolactin and PCOS

Prolactin is responsible for the production of breast milk. Your prolactin level remains elevated for up to several months after breastfeeding. However, your prolactin level can also be elevated without breastfeeding. Because prolactin affects ovulation, it can disrupt your menstrual cycle. Excess prolactin causes you to produce more male hormones. If you use the contraceptive pill, your prolactin levels will be elevated; partly for this reason, we indicate that this test is not suitable for women who use the pill.