These tests should be interpreted by a health care professional familiar with them, such as an endocrinologist or reproductive endocrinologist. The best time to be tested is in the morning shortly after the beginning of a menstrual period (you may need medication to induce menstruation). You should know that birth control pills, because they change hormonal balance, might make the tests worthless.
Your health care professional may also order ultrasound imaging of the ovaries to look for the characteristic picture of multiple cysts. The test involves insertion of a probe into the vagina. Such a test, however, is not definitive, since it is very common for women without PCOS to have cysts; it is also common for women with PCOS not to have cysts. The ultrasound, however, can help confirm a diagnosis and is the single most reliable way of making a diagnosis as long as it is done by a physician who understands variations in the ovarian image. It also allows simultaneous examinations of the endometrial lining for abnormalities. Health care professionals rarely remove benign cysts, opting more often to prescribe lifestyle modifications and medication to treat symptoms.
If you have PCOS, you should be tested and treated for other conditions that are associated with the syndrome (or thought to be), such as insulin resistance and type II diabetes, obesity, high blood pressure and elevated blood lipids (cholesterol and triglycerides). The connection between PCOS and insulin and lipid problems is a strong one, though the reasons are not thoroughly understood.
About one in 10 cases of diabetes in premenopausal women can be linked to PCOS. The syndrome may also boost risk for heart disease, although long-term, definitive studies have yet to be completed.
Some drugs are associated with “masculinization” symptoms, most notably steroids. Alternative medications may take care of the problem.
Occasionally, such symptoms are the result of an androgen-producing tumor. If your testosterone level is above 200 mg/dl, your health care professional may want to investigate further.