Understand the nuances of polycystic ovary syndrome (PCOS) testing in Australia, the importance of early diagnosis, and the tests used to effectively diagnose the condition. Also, find out when these diagnostic procedures should be considered.

Key Takeaways:

• PCOS is characterised by elevated androgen levels and presents with symptoms such as irregular periods and weight gain.
• No single definitive test for PCOS exists; a combination of blood tests, ultrasounds and physical exams is often used.
• Early diagnosis and intervention can help manage and reduce the potential complications of PCOS.
• Lifestyle changes, medications and natural remedies can aid in managing PCOS symptoms.

Polycystic ovary syndrome (PCOS) affects a significant number of Australian women in their reproductive years. More than 80 percent of women with PCOS have high androgen levels, irregular menstrual cycles and cysts in their ovaries. Understanding how to test for PCOS and recognising its symptoms can pave the way for effective management.

Why testing is essential

Because the symptoms of PCOS and other health conditions overlap, it is critical to perform sufficient tests to ensure an accurate diagnosis. By ruling out other causes, one can embark on a tailored treatment journey for PCOS.

Available tests for PCOS in Australia

Blood test for PCOS

A comprehensive hormonal profile can highlight elevated androgens and other imbalances. Common blood tests include:

• Testosterone level
• Sex hormone-binding globulin (SHBG)
• 17-hydroxyprogesterone
• Thyroid function tests
• Prolactin level
• Fasting glucose and insulin levels

Pelvic ultrasound

This imaging technique evaluates the ovaries' size and appearance, looking for multiple small cysts that could indicate PCOS.

Physical examination

This can identify signs like increased body hair, acne and any other physical manifestations related to high androgen levels.

Oral glucose tolerance test

Beyond assessing for PCOS, this test is essential in determining one's risk of developing type 2 diabetes, a common comorbidity present in patients with PCOS.

When to consider testing for PCOS

Understanding when to seek testing for polycystic ovary syndrome is essential for early intervention and effective management. Recognising the stages of PCOS symptoms can help guide this decision.

Early-stage symptoms:

PCOS can start showing signs soon after the onset of menstruation. In this initial stage, the symptoms can be mild and often overlooked:

• Menstrual irregularities: Periods may be slightly irregular or heavier than usual.
• Mild acne: Not always related to PCOS, but it can be an early sign when combined with other symptoms.
• Mood swings: Hormonal imbalances might contribute to mood fluctuations.
• Weight fluctuations: Changes in weight, especially around the waistline, might be observed.

Mid-stage symptoms:

As the condition progresses, the symptoms become more pronounced. By this stage, many women start noticing that something might be off:

• Increased hair growth: Unusual growth of hair on the face, chest, back and other areas where men typically grow hair.
• Thinning hair: A noticeable thinning of hair on the scalp.
• More pronounced menstrual irregularities: Missing periods or having very irregular cycles.
• Weight gain: Despite efforts to maintain a regular diet and exercise, some women have difficulties with weight concerns.

Advanced-stage symptoms:

If PCOS goes unchecked and unmanaged, symptoms can become more severe and might have a significant impact on a woman's quality of life:

• Infertility: Due to irregular ovulation or a lack of ovulation altogether.
• Darkened patches of skin: Especially in neck creases, in the groin, and under the breasts.
• Severe acne, oily skin or dandruff: Hormonal imbalances can lead to skin and scalp issues.
• Sleep apnoea: Some women with PCOS, especially those who are overweight, may experience interrupted sleep or sleep apnoea.

When should you consider testing?

• Awareness of family history: If there's a family history of PCOS or related symptoms, it's wise to get tested immediately even with mild symptoms.
• Persistent symptoms: If you've been experiencing any combination of the above symptoms consistently over the past few months, it's essential to consult with a healthcare provider.
• Planning for pregnancy: If you're trying to conceive and have noticed irregularities in your menstrual cycle or any other PCOS-related symptoms, it's a good idea to get tested.
• Unexplained weight gain: If you've gained significant weight without a clear reason, especially around the waist, and find it challenging to lose it, this could be an indication of PCOS.

Lifestyle interventions, management and complications of PCOS

Polycystic ovary syndrome isn't just about managing present symptoms; it’s about mitigating the risk of various complications associated with the condition. These complications, such as cardiovascular disease and type 2 diabetes, can significantly impact a woman's quality of life. Therefore, lifestyle interventions are pivotal not just for symptom relief but also for prevention.

Complications of PCOS:

1. Endometrial cancer: Women with PCOS often have prolonged menstrual cycles, leading to the endometrial lining not shedding regularly. This can increase the risk of endometrial cancer.
2. Cardiovascular disease: PCOS can lead to risk factors like high blood pressure, obesity and insulin resistance, which elevate the risk of heart disease.
3. Type 2 diabetes: Women with PCOS are often insulin resistant, which can lead to elevated blood sugar levels and, eventually, type 2 diabetes.
4. Obesity: Many with PCOS struggle with weight gain, especially around the abdomen. This type of weight distribution can increase health risks.
5. Infertility: PCOS is a common cause of infertility in women due to irregular ovulation.
6. Mental health issues: PCOS sufferers often report increased rates of anxiety, depression and other mood disorders, possibly due to the physical and emotional strain of the condition.

Lifestyle interventions to counter these complications:

1. Healthy diet: Consuming a diet rich in whole grains, lean proteins, healthy fats and ample fruits and vegetables can combat insulin resistance and reduce weight. Foods with a low glycaemic index can help regulate blood sugar levels, which decreases the risk of type 2 diabetes.
2. Regular exercise: Incorporating both aerobic and resistance training exercises can improve insulin sensitivity, help in weight management and reduce cardiovascular risk factors. Regular activity can also boost mood and alleviate mental health concerns.
3. Stress management: Chronic stress can exacerbate insulin resistance and contribute to weight gain. Activities like mindfulness, deep breathing and journaling can manage stress effectively.
4. Avoid smoking: Smoking can exacerbate cardiovascular risks in PCOS patients. Quitting can reduce these risks significantly.
5. Regular health check-ups: Regular consultations with healthcare providers can monitor blood pressure, cholesterol levels and blood sugar levels, ensuring any deviations are addressed promptly.

While PCOS remains a common challenge, awareness, timely diagnosis and effective management can ensure a quality life for those affected. Moreover, tracking and understanding your body's glucose levels can be a proactive step in managing PCOS.

The Vively metabolic health app is an excellent tool that can help users understand individual responses to lifestyle factors, improve their glucose control and hence contribute to their general wellbeing.