PCOD tests explained: hormone, sugar and heart checks

The list of tests can look long and a bit frightening. The tests sit in six groups, and none of them hurts more than a blood draw and a scan. Your doctor chooses only what suits you. There is no single PCOD test, so these checks work together.

Here is what each group looks at, in plain words.

Hormone tests

These look at the signals between your brain, ovaries and adrenal glands.

• LH and FSH. These are the brain's signals to the ovaries. Doctors often read them together because the balance matters.
• AMH. A hormone made by the small follicles in the ovary. It gives a sense of how many follicles there are.
• Prolactin. A hormone that, when high, can disturb periods. It is tested because prolactin problems can look like PCOD.
• TSH. The usual thyroid test. Thyroid problems can also look like PCOD, which is why they are always tested.
• Free testosterone, SHBG and DHEA-S. These look at androgens. SHBG is a protein that carries testosterone in the blood, and DHEA-S is an androgen made mostly by the adrenal glands.

Some hormone levels change with the day of the cycle. If timing matters for your test, your doctor will tell you.

Sugar tests

Insulin resistance is common in PCOD, so sugar handling is checked.

• Fasting sugar and fasting insulin. Blood drawn after an overnight fast.
• HbA1c. This reflects your average blood sugar over the last few months, so it does not change with one meal.
• OGTT. A glucose tolerance test. Blood sugar is checked before and after a sugary drink.
• HOMA-IR. Not a separate blood draw. It is a number worked out from your fasting sugar and insulin, and it hints at insulin resistance.

Heart checks

PCOD and insulin resistance can raise the risk of heart problems later, so doctors look early.

• Lipid profile. A blood test for cholesterol and triglycerides.
• Blood pressure. Measured in the clinic.
• hs-CRP. A marker of low-grade inflammation in the body.
• ECG or ECHO, only if needed. These look at the heart's rhythm and structure, and are used when there is a reason.

Vitamin, iron and liver tests

• Vitamin D, vitamin B12 and iron. Low levels can cause tiredness and hair fall, so they are checked alongside the PCOD tests.
• Liver tests. Fatty liver is more common in PCOD, so doctors check liver health.

If hair fall or tiredness is your main complaint, these tests may tell you more than the hormone panel.

Pelvic ultrasound

A scan of the ovaries and womb lining. It can show small follicles in the ovary and how thick the lining is. A separate article explains the scan, including why a scan alone is not used to diagnose PCOD in teenagers, in the first 8 years after periods start.

Body measurements

Weight, waist, body composition and sometimes a skin and hair analysis. A tape measure and a scale cost nothing and say something useful. Waist matters because belly fat is linked to insulin resistance. Body composition shows fat and muscle, not only weight, which can help when the scale does not tell the whole story.

How to get ready

A little preparation makes the visit smoother.

• Ask whether you need to fast, and for how long.
• Bring old reports, so the doctor can compare.
• Carry a written list of medicines and supplements.
• Note the first day of your last period. Some tests depend on the cycle day.
• Drink water unless told otherwise. It makes blood draws easier.

Reading your own report

Reports mark results as high or low against a range. A flagged value does not always mean a problem, and a value inside the range does not always mean all is well. Normal ranges differ between labs. Ask your doctor to explain the pattern, not just the one number.

Please do not decide a diagnosis from a report you found online. That path leads to confusion, and sometimes to supplements nobody needs.

When to repeat tests

Doctors repeat some tests at review visits to see how you are doing, and again when the plan changes. In a structured programme, repeat tests and measurements often come at the end of month 3. Ask your doctor what is right for you and why.

This article is education, not a diagnosis. A doctor decides which tests you need and what the results mean.