Women's Health
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October 31, 2024

8 Essential Lab Tests for Patients with a Family History of Polycystic Ovary Syndrome (PCOS)

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Medically Reviewed by
Updated On
November 4, 2024

If you have a family member with Polycystic Ovary Syndrome (PCOS), you may have questions about what it means for your own health. PCOS is a condition that can affect hormones, energy levels, and overall wellness, especially in women. 

Having a close relative with PCOS doesn’t mean you’ll develop it, too, but it does mean you may be more likely to experience similar challenges. Staying on top of your health with regular lab tests is one way to catch any potential issues early. This article covers eight lab tests that can be especially useful if PCOS is in your family.

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The Link Between Family History and PCOS Risk

PCOS is known to have a genetic component, meaning that if a close family member—such as a mother or sister—has PCOS, your risk of developing it may be higher. 

This inherited risk is tied to specific genes that influence hormone production, metabolic processes, and ovarian function, all of which play a role in PCOS. 

A study published in the International Journal of Environmental Research and Public Health found that women whose mothers had PCOS had nearly a threefold higher risk of developing the condition themselves.

Research has identified potential genetic markers that may contribute to this familial link, helping scientists better understand genetics' role in PCOS risk.

Modifiable vs. Non-Modifiable Risks

While genetic predisposition is a non-modifiable factor, lifestyle choices can be adjusted to support overall wellness and reduce the severity of potential PCOS symptoms

Modifiable risk factors include diet, exercise, and stress management, all of which impact hormonal balance, insulin sensitivity, and weight management. A family history of PCOS doesn’t guarantee you’ll develop the condition, but understanding and managing modifiable risks may help lessen its impact on your life if it does arise.

Regular lab tests play an important role in proactive health management for people with a family history of PCOS. These tests can help identify subtle changes in hormones, blood sugar, and other key indicators, making it easier to catch imbalances early. 

You and your healthcare provider can make timely adjustments to support a balanced lifestyle and overall wellness by monitoring these factors.

The 8 Essential Lab Tests

For those with a family history of PCOS, these lab tests can offer valuable insights into hormone balance, blood sugar, and overall health. Here are eight key tests to consider.

1. Luteinizing Hormone (LH) and Follicle-Stimulating Hormone (FSH) Levels

LH and FSH are hormones that are central to regulating the menstrual cycle. FSH stimulates the ovaries to produce follicles (which contain eggs), while LH triggers the release of an egg during ovulation. Together, they help maintain the balance of the menstrual cycle.

Why They’re Important

In people with PCOS, the balance between LH and FSH is often disrupted. Many people with PCOS have a higher LH-to-FSH ratio, which can interfere with ovulation and contribute to irregular cycles and other symptoms. Checking the LH/FSH ratio can be a helpful step in identifying possible signs of PCOS.

Interpreting Results

An elevated LH-to-FSH ratio (often higher than 2:1) is a common finding in people with PCOS, though it’s not a definitive diagnostic marker on its own. Higher ratios may indicate hormonal imbalance, which is often linked to symptoms of PCOS.

Here are examples of these tests offered through Rupa Health:

2. Total and Free Testosterone Levels

Testosterone is an androgen hormone often associated with male traits but also present in smaller amounts in females. Total testosterone includes all testosterone in the body, while free testosterone measures the active portion available to tissues.

Why They’re Important

High levels of testosterone are common in PCOS and can contribute to symptoms like excess hair growth, acne, and irregular periods. Monitoring both total and free testosterone levels helps in assessing androgen excess, which is a typical feature of PCOS.

Addressing Elevated Levels

If testosterone levels are high, treatment options might include lifestyle changes, medications, or other therapies aimed at balancing hormones. These approaches can help reduce androgen-related symptoms and support overall hormonal health.

Here are examples of this test offered through Rupa Health:

3. Dehydroepiandrosterone Sulfate (DHEA-S) Test

DHEA-S is an androgen hormone produced primarily by the adrenal glands. While similar to testosterone, DHEA-S specifically reflects adrenal gland activity rather than ovarian function.

Why It’s Important

High DHEA-S levels can be linked to PCOS but may also indicate adrenal disorders. Measuring DHEA-S helps differentiate PCOS-related androgen excess from other conditions that may cause similar symptoms, such as adrenal hyperplasia.

Managing Abnormal Levels

If DHEA-S levels are elevated, your healthcare provider may recommend additional tests to rule out adrenal disorders. Identifying the source of hormone imbalance is important for choosing the best treatment approach.

Here are examples of this test offered through Rupa Health:

4. Prolactin Levels

Prolactin is a hormone primarily responsible for stimulating milk production after childbirth. The pituitary gland produces it and typically remains low in non-pregnant individuals.

Why It’s Important

Elevated prolactin levels can lead to symptoms that overlap with PCOS, such as irregular menstrual cycles and infertility. This makes it helpful to check prolactin levels to ensure these symptoms aren’t caused by another condition, like hyperprolactinemia.

Interpreting Results

If prolactin levels are high, your healthcare provider may evaluate for prolactinoma, a benign tumor of the pituitary gland that can cause excess prolactin production. Identifying this early can help target the right treatment.

Here are examples of this test offered through Rupa Health:

5. Thyroid Function Tests (TFTs)

Thyroid function tests measure thyroid-stimulating hormone (TSH) levels and thyroid hormones T3 and T4. These hormones regulate metabolism, energy levels, and menstrual function, making them essential to overall health.

Why They’re Important

Thyroid disorders, such as hypothyroidism (low thyroid function) or hyperthyroidism (high thyroid function), can cause symptoms that mimic or worsen PCOS, including irregular periods and fatigue. Checking thyroid levels can help clarify whether thyroid health impacts menstrual function or other symptoms.

Addressing Thyroid Disorders

If an imbalance is detected, treatments like thyroid medication or lifestyle adjustments can help regulate thyroid hormone levels, supporting more balanced cycles and improved energy. Proper thyroid management can also improve other symptoms that overlap with PCOS.

Here are examples of this test offered through Rupa Health:

6. Oral Glucose Tolerance Test (OGTT) and Insulin Levels

The Oral Glucose Tolerance Test (OGTT) measures how well the body manages blood sugar over time, while insulin level testing evaluates the body’s response to blood sugar by measuring insulin, a hormone that helps cells use glucose for energy. Together, these tests assess blood sugar control and potential insulin resistance.

Why They’re Important

Many people with PCOS experience insulin resistance, where the body’s cells don’t respond properly to insulin. This can lead to elevated blood sugar levels and an increased risk of developing Type 2 diabetes. Identifying insulin resistance early allows for proactive management, helping to lower health risks over time.

Managing Insulin Resistance

If insulin resistance is detected, lifestyle changes such as dietary adjustments and regular exercise can improve the body’s response to insulin. Sometimes, healthcare providers may suggest medications to support healthy blood sugar levels, which can also help manage PCOS symptoms.

Here are examples of this test offered through Rupa Health:

7. Lipid Profile

A lipid profile measures different types of fats in the blood, including total cholesterol, LDL (bad cholesterol), HDL (good cholesterol), and triglycerides. These markers help evaluate heart health and the risk for cardiovascular issues.

Why It’s Important

People with PCOS often have higher levels of LDL cholesterol and triglycerides, along with lower HDL cholesterol, which can increase the risk of heart disease. Monitoring lipid levels provides insight into cardiovascular health, which is important because PCOS can elevate heart-related risks.

Improving Lipid Levels

If lipid levels are outside the healthy range, lifestyle adjustments like eating a balanced diet, engaging in regular physical activity, and avoiding smoking can help improve them. Medications may sometimes be recommended to manage cholesterol and support heart health.

Here are examples of this test offered through Rupa Health:

8. Anti-Müllerian Hormone (AMH) Levels

Anti-Müllerian Hormone (AMH) is a hormone produced by the small follicles in the ovaries and is used as an indicator of ovarian reserve, or the number of eggs remaining in the ovaries.

Why It’s Important

People with PCOS often have higher AMH levels, which reflect an increased number of small follicles in the ovaries. High AMH levels alone aren’t enough to diagnose PCOS but can support other findings related to the condition.

Implications for Fertility

AMH levels provide insight into reproductive potential, which can be helpful for those considering family planning. In patients with PCOS, high AMH may also correlate with irregular ovulation, impacting fertility. Understanding AMH levels helps both patients and healthcare providers make informed decisions about fertility and reproductive health planning.

Here are examples of this test offered through Rupa Health:

Additional Preventative Measures

Beyond lab tests, lifestyle habits and proactive choices may help manage symptoms and lower the risk of related health concerns. Small changes in daily routines, regular check-ups, and family support can significantly impact long-term well-being.

Lifestyle Modifications

Maintaining a balanced diet rich in whole foods and engaging in regular physical activity can help improve hormone balance, support healthy weight, and enhance insulin sensitivity. Small adjustments, like adding fiber and reducing processed sugars, may help manage PCOS symptoms over time.

Regular Medical Check-Ups

Routine check-ups allow for ongoing monitoring of symptoms and lab markers, helping to catch any changes early. Your healthcare provider can adjust treatments as needed, offering more tailored care as your health evolves.

Family Education and Support

Involving family members in your journey can boost both awareness and support. Educating relatives about PCOS, especially those who may also be at risk, encourages shared preventative strategies and helps everyone feel more informed and proactive.

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Key Takeaways

  • Having a family history of PCOS increases your risk of developing the condition, but lifestyle modifications can help manage this risk by supporting hormone balance and metabolic health.
  • Regular lab tests, including hormone levels, glucose tolerance, lipid profile, and thyroid function, are essential for detecting early changes and managing symptoms associated with PCOS.
  • Proactive lifestyle changes, routine check-ups, and family support can significantly improve long-term health and help manage or mitigate symptoms associated with PCOS.
The information in this article is designed for educational purposes only and is not intended to be a substitute for informed medical advice or care. This information should not be used to diagnose or treat any health problems or illnesses without consulting a doctor. Consult with a health care practitioner before relying on any information in this article or on this website.

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Johns Hopkins
Educational/Medical Institution
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Hey practitioners! 👋 Join Dr. Chris Magryta and Dr. Erik Lundquist for a comprehensive 6-week course on evaluating functional medicine labs from two perspectives: adult and pediatric. In this course, you’ll explore the convergence of lab results across different diseases and age groups, understanding how human lab values vary on a continuum influenced by age, genetics, and time. Register Here! Register Here.

Hey practitioners! 👋 Join Dr. Terry Wahls for a 3-week bootcamp on integrating functional medicine into conventional practice, focusing on complex cases like Multiple Sclerosis. Learn to analyze labs through a functional lens, perform nutrition-focused physical exams, and develop personalized care strategies. Register Here.