PCOS and hormone profiling: How does it work?

Polycystic Ovarian Syndrome is one of the most common endocrinological diagnosed in women. Usually referred to as a lifestyle disorder, PCOS can further lead to many complications in the body, if not treated in the right way. Addressing this, Dr Preeti Rastogi, Additional Director, Obstetrics and Gynaecology, Fortis Memorial Research Institute, Gurugram spoke to HT Lifestyle and said, “It is a heterogeneous disorder of uncertain etiology, but research suggest that there is complex interactions between genetic, environmental, and behavioural factors contribute. The diagnosis of PCOS is made if two of the three criteria of androgen excess (hormone profile), ovulatory dysfunction or polycystic ovaries on ultrasound are met. Symptoms of PCOS include amenorrhea or oligo amenorrhoea, hirsutism, obesity, acne, androgenic alopecia and reproductive disorders.”

Adding to this, Dr. Namita Jain, Consultant- Obstetrics & Gynaecology, Paras Hospitals, Gurugram told HT Lifestyle, “Hormone profiling is one of the preliminary tests performed to diagnose PCOS (Polycystic Ovarian Syndrome). When a woman experiences hormonal changes preventing a regular course of the menstrual cycle, the doctor may suspect the presence of PCOS condition. To conclude, gynecologists advise patients to undergo hormone profiling, which helps determine whether the hormonal changes are associated with PCOS.”

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Dr Namita Jain further noted down how hormone profiling works:

Measurement of hormones: Hormone profiling for PCOS includes the measurement of various hormones, mainly testosterone, the hallmark of this condition. Testosterone higher than average in hormone profiling indicates the presence of PCOS condition.

Types of hormones: Other hormones under scanner for PCOS diagnosis are estrogen, Sex Hormone Binding Globulin (SHBG), Follicle Stimulating Hormone (FSH), Luteinizing Hormone (LH), LH/FSH ratio, prolactin, DHEAS (Dehydroepiandrosterone sulfate), androstenedione and Thyroid Stimulating Hormone (TSH).

Impact of SHBG: Sex Hormone Binding Globulin (SHBG) lower than average in hormone profiling indicates the presence of PCOS.

Measurement of FSH: To rule out PCOS, FSH must be above average, and LH must be normal or below average. While LH/FSH ratio does play a much more significant role in determining PCOS, it shows elevated levels of LH.

Impact of Prolactin: In the case of prolactin hormone, it should come in the average or low range during PCOS hormone profiling. However, if it is high, it may rule out PCOS.

Estrogen and androstenedione: While estrogen will be average or slightly higher than average if the PCOS condition is present, the androstenedione hormone will also appear elevated than the usual range.

Other tests: The hormone profiling for PCOS, followed by other tests such as the Lipid profile, glucose test, insulin test, 17-hydroxyprogesterone, IGF-1 cortisol, and creatinine tests, ascertain the presence of PCOS condition.