Hormone levels and PCOS

PCOS (polycystic ovarian syndrome) affects up to 1 in 10 women and comes with a variety of symptoms such as weight gain, abnormal periods, infertility, acne, excessive hair growth in places where men usually grow hair (like the face and chin), and male-pattern baldness.

Generally, PCOS can be diagnosed if women display two out of three major symptoms: high levels of androgens (male sex hormones), ovarian cysts, or irregular periods.

To diagnose PCOS, doctors will ask questions about your medical and family history and use a combination of methods: observing symptoms, a physical exam, a pelvic ultrasound, and blood tests.

Blood tests may reveal abnormal hormone levels (such as elevated androgens) that can help diagnose PCOS or rule out other conditions that may cause PCOS-like symptoms.

Here are some of the hormones that may be tested to help diagnose PCOS.

Testosterone

All women produce small amounts of testosterone, but women with PCOS may have higher than normal levels, which can interfere with menstruation, ovulation, and cause traits like facial hair.

Doctors may also look out for elevated levels of other androgens like androstenedione or DHEA-S (dehydroepiandrosterone sulfate).

The tricky thing is that while many women with PCOS may show high androgen levels, some may have normal levels.

Sex hormone binding globulin (SHBG)

Women with PCOS may have lower than normal levels of SHBG, a blood protein that helps regulate the amount of testosterone tissues receive.

SHBG binds sex hormones like testosterone and estrogen and transports them in the blood as inactive forms, thus reducing their effect on the body.

Follicle-stimulating hormone (FSH) and Luteinizing hormone (LH)

FSH and LH are hormones which encourage ovulation. FSH stimulates growth of the egg and LH triggers its release from the ovaries.

Usually, FSH and LH levels are found in equal amounts, though LH surges before ovulation. Women with PCOS may have higher than normal LH levels compared to FSH.

However, this difference doesn’t confirm a PCOS diagnosis, and can be hard to detect with random blood samples as the hormones are regularly released from the pituitary gland.

Progesterone

Progesterone is produced after ovulation and thickens the uterine lining in preparation for possible pregnancy. Usually, about 7 days after ovulation, high progesterone levels indicate that ovulation happened.

For women with PCOS, low progesterone levels after ovulation may reveal that the egg was not actually released. This can inform how doctors treat possible infertility or ovulation problems, according to Evelina Sterling, health specialist and co-author of the book “Living with PCOS.”

Estrogen

Estrogen is a female sex hormone secreted mainly by the ovaries, and by the adrenal glands in small amounts. It works with progesterone to promote menstruation.

Women with PCOS may have normal or higher than normal levels of estrogen as the high insulin and testosterone circulating in their body may be converted to estrogen.

Human chorionic gonadotropin (hCG)

This hormone indicates pregnancy. It is released by cells around the growing embryo and helps prepare a woman’s body for pregnancy.

A doctor may do a pregnancy test to measure hCG levels and rule out pregnancy as a cause for PCOS-like symptoms.

Prolactin

This is a hormone that promotes milk production in nursing mothers. Women with PCOS may have normal or elevated levels of prolactin (a condition known as hyperprolactinemia).

Testing prolactin levels may also help rule out hyperprolactinemia, which may resemble PCOS as it interferes with fertility and menstruation.

Thyroid-stimulating hormone (TSH)

TSH is produced by the thyroid gland to help regulate the body’s metabolism.

Testing TSH levels can help rule out thyroid disorders such as an underactive thyroid, known as hypothyroidism.

If you’re diagnosed with PCOS, your doctor may also check your insulin and glucose levels as PCOS is also linked with insulin resistance, meaning your body doesn’t respond to insulin. This can increase your risk for Type 2 diabetes. Women with PCOS may also have high cholesterol which can increase the risk of heart disease.

If you have PCOS or have symptoms that may indicate PCOS, talk to your doctor.

While there is no cure for PCOS, treatment such as birth control pills can help manage symptoms. If you’re looking for medical advice or treatment for PCOS, get started with Alpha today.