PCOS panel

Are your periods irregular, do acne or excessive hair growth trouble you, or are you having difficulty becoming pregnant? The PCOS panel checks ten hormones from one blood draw to help confirm polycystic ovary syndrome (PCOS) and rule out other causes of similar symptoms. The results help you reach answers sooner with your gynaecologist or endocrinologist.

Who the panel is for

• your periods are infrequent, irregular or absent, for example cycles longer than 35 days;
• you have excessive facial, chest or abdominal hair, adult acne or thinning hair on the crown;
• you have difficulty becoming pregnant and irregular cycles;
• ultrasound has described “polycystic” ovaries and the doctor wants to check hormones;
• you are gaining weight around the waist or have insulin resistance alongside one of the above symptoms.

What the panel detects

PCOS is one of the most common hormonal disorders in women of reproductive age. Diagnosis requires at least two of three signs: irregular ovulation, excess male hormones (in results or as hair growth and acne), and typical ovarian appearance on ultrasound, while other causes must be excluded. The panel helps with both steps:

• Testosterone, free testosterone and SHBG: show whether there are excessive male hormones in blood. SHBG is a protein that binds testosterone; when low, there is more active testosterone.
• DHEA-S: a male hormone from the adrenal gland, helping distinguish the source of excess.
• LH and FSH: pituitary hormones controlling the ovaries (more about LH).
• Oestradiol: the main female hormone, helping assess ovarian function.
• 17-hydroxyprogesterone: used to rule out non-classic congenital adrenal hyperplasia, an inherited disorder very similar to PCOS (more about 17-hydroxyprogesterone).
• Prolactin and TSH: elevated prolactin and thyroid diseases also disrupt cycles and must therefore be excluded.

The test and preparation

Blood is taken from a vein. Attend in the morning between 7 and 10 o’clock, at least two hours after waking, and rest for around 30 minutes before collection because testosterone and prolactin depend on time of day and stress. Because of testosterone, attend after fasting for 8 to 12 hours (water is allowed).

If you menstruate, have blood collected between cycle days 2 and 5, usually day 2 or 3 (the first day of menstruation is day 1), unless your doctor says otherwise. If periods are absent or very infrequent, you may attend any day. Mention hormonal contraception or corticosteroids, because they alter results. If you take biotin (for example, hair and nail supplements), mention this at collection.

What your results mean

• Elevated testosterone or free testosterone, low SHBG: excess male hormones, common in PCOS. Other causes can produce the same results, so the doctor considers the whole picture.
• LH higher than FSH: a common but not essential sign of PCOS; not a diagnosis by itself.
• Elevated 17-hydroxyprogesterone: may indicate non-classic congenital adrenal hyperplasia, leading to endocrinology investigation.
• Elevated prolactin or abnormal TSH: symptoms may originate from the pituitary or thyroid rather than PCOS.
• High FSH with low oestradiol: suggests reduced ovarian function rather than PCOS.
• Very high testosterone or DHEA-S, particularly with sudden changes such as a deeper voice: requires prompt medical examination.

Reference values are printed on the report. Normal hormones do not rule out PCOS, because diagnosis may also be based on cycles, skin signs and ultrasound. Results are interpreted by a gynaecologist or endocrinologist, who usually also checks blood sugar and fats in PCOS, for example glucose and HbA1c or glucose tolerance testing.

How to arrange testing

You can come for blood collection without an appointment or referral at one of our branches throughout Croatia (listed on the Contactpage). Prices for all tests and panels are listed in the price list. If acne is the main concern and your cycle is regular, the doctor may suggest the smaller Acne panel.

Frequently asked questions

Can PCOS be established through a blood test alone?

No. Hormones show excess male hormones and exclude other causes; the doctor diagnoses using cycles, examination and ultrasound.

Which cycle day should PCOS hormones be tested?

For regular periods, between cycle days 2 and 5, usually day 2 or 3. If periods are absent, any day.

Can I have hormone testing while taking contraceptive pills?

Yes, but results do not then show the actual state, because contraception lowers testosterone and pituitary hormones. Do not stop it yourself: the doctor assesses whether a break is needed before collection, usually around three months, with another form of pregnancy protection.

Is PCOS the same as polycystic ovaries?

No. Many women have ovaries with numerous small follicles on ultrasound without PCOS. Other signs are also needed for diagnosis.