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    Hormone Levels and PCOS

    Polycystic Ovary Syndrome (PCOS), ObGyn Nurses, Pregnancy and Birth, Infertility

    Remember that PCOS cannot be diagnosed by symptoms alone.  PCOS is a very complicated endocrine disorder.  Blood tests to measure hormone levels, an ultrasound to look at your reproductive organs and thorough personal and family histories should be completed before a PCOS diagnosis is confirmed. Depending on your symptoms, your physician will determine exactly which tests are necessary. Assessing hormone levels serves two major purposes. First of all, it helps to rule out any other problems that might be causing the symptoms. Secondly, together with an ultrasound and personal and family histories, it helps your doctor confirm that you do have PCOS. Most often, the following hormone levels are measured when considering a PCOS diagnosis:

    • Lutenizing hormone (LH)

    • Follicle-stimulating hormone (FSH)

    • Total and Free Testosterone

    • Dehydroepiandrosterone sulfate (DHEAS)

    • Prolactin

    • Androstenedione

    • Progesterone

    Other hormones that may be checked include:

    • Estrogen

    • Thyroid stimulating hormone (TSH)

    In addition, glucose, cholesterol (HDL, LDL and triglicerides) levels might also be assessed. 

    Lutenizing Hormone (LH) and Follicle Stimulating Hormone (FSH)
    LH and FSH are the hormones that encourage ovulation. Both LH and FSH are secreted by the pituitary gland in the brain. At the beginning of the cycle, LH and FSH levels usually range between about 5-20 mlU/ml. Most women have about equal amounts of LH and FSH during the early part of their cycle. However, there is a LH surge in which the amount of LH increases to about 25-40 mlU/ml 24 hours before ovulation occurs. Once the egg is released by the ovary, the LH levels goes back down.

    While many women with PCOS still have LH and FSH still within the 5-20 mlU/ml range,  their LH level is often two or three times that of the FSH level. For example, it is typical for women with PCOS to have an LH level of about 18 mlU/ml and a FSH level of about 6 mlU/ml (notice that both levels fall within the normal range of 5-20 mlU/ml).  This situation is called an elevated LH to FSH ratio or a ratio of 3:1. This change in the LH to FSH ratio is enough to disrupt ovulation. While this used to be considered an important aspect in diagnosing PCOS, it is now considered less useful in diagnosing PCOS, but is still helpful when looking at the overall picture.


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