PCOS & Irregular Cycles Blood Test Panel

Polycystic ovary syndrome is the most common cause of irregular cycles combined with signs of androgen excess, but it is a diagnosis of exclusion. Several other conditions produce a very similar picture and are managed quite differently, so the point of this panel is to work through them rather than to confirm a conclusion you have already reached.

Androgen excess. Testosterone (free and total) with SHBG shows how much biologically active androgen is circulating. SHBG matters because total testosterone alone can look normal while free testosterone is high. DHEA-S indicates whether the adrenal glands are a significant source.

Nonclassic congenital adrenal hyperplasia. 17-hydroxyprogesterone is the test that separates NCAH from PCOS. The two are close to indistinguishable clinically, and this is the single most useful addition to a workup that would otherwise stop at "probably PCOS".

Thyroid disease and high prolactin. Both cause irregular or absent cycles and both are straightforward to treat, so they are ruled out early. TSH covers the first, prolactin the second.

Metabolic health. HbA1c and fasting glucose describe how your body is handling blood sugar. Insulin resistance is common alongside PCOS and is often where treatment starts.

These results describe the hormonal and metabolic picture. They do not by themselves diagnose PCOS — that requires a clinician to combine your symptoms, cycle history and sometimes an ultrasound with these numbers.