Check more than bloods
Discuss blood pressure (annually), periods, sleep and emotional wellbeing.
Beyond 10 minutes · Free guide 04
PCOS: know what to check, and why.
Your PCOS conversation should include more than your periods.
Updated 12 October 2026 · Adult health education
PCOS is also now called polyendocrine metabolic ovarian syndrome (PMOS). Keep a plan for your symptoms and longer-term health, rather than ordering every hormone test every year.
Diagnosis and ongoing monitoring are different conversations. Tell your clinician about your cycle, acne, excess hair growth, scalp thinning, medicines and pregnancy plans.
Blood tests to discuss
Tests are chosen for your symptoms and medical history. This is a discussion guide, not a request for every test.
| Test | Why it may help |
|---|---|
| Blood glucose assessment | Check at diagnosis and generally every 1-3 years, according to diabetes risk. A 75 g oral glucose tolerance test is most accurate; HbA1c and/or fasting glucose are alternatives when it cannot be done, but can miss cases. |
| Lipid profile | Checks cholesterol and triglycerides at diagnosis. Repeat timing depends on results and cardiovascular risk. It does not diagnose insulin resistance. |
| Hormone tests for diagnosis | Testosterone and SHBG may help assess androgen excess. Thyroid, prolactin or other tests may be needed to exclude alternative causes, depending on the presentation. |
| B12 if taking metformin | Test with suggestive symptoms; periodic monitoring may be appropriate with risk factors. There is no single testing interval for everyone. |
| Symptom-led additional tests | FBC/ferritin for heavy bleeding, fatigue or hair loss; folate, vitamin D, kidney or liver tests if clinically indicated. These are not all routine PCOS tests. |
Your next steps
Discuss pregnancy plans early
Ask about an oral glucose tolerance test before conception or fertility treatment.
Make a cycle plan
If long gaps between periods are not explained by hormonal treatment, pregnancy or breastfeeding, contact your GP. Discuss protection of the womb lining. Some hormonal treatments protect it without regular bleeding.
Know what is not routine
Fasting insulin tests are not recommended for routine PCOS care. LH:FSH ratio is not a stand-alone diagnostic test. A normal ultrasound alone does not exclude PCOS.
Take these questions to your appointment
- When is my next glucose and cholesterol check?
- Do I need B12 monitoring on metformin?
- Is my womb lining protected?
- Which symptoms need treatment or further investigation?
When to get help
Rapidly developing excess hair growth, voice deepening or other marked new hormone-related changes need prompt assessment, rather than being assumed to be PCOS.
Sources and further reading
- 2023 International PCOS guideline: recommendations ↗
- NHS: PMOS (formerly PCOS) ↗
- MHRA: metformin and vitamin B12 ↗
- Primary Care Dermatology Society: hyperandrogenism ↗
Adapted from Doctor Barbara's educational content, with source-based updates. General information for adults; individual care, pregnancy and children's care need tailored advice. This guide cannot diagnose you or replace your healthcare professional.