Lindsay Harnish

 

What other investigations would you like to order?

• a.Total and Free testosterone – free testosterone is the most sensitive test for PCOS, it will be elevated
• b.LH and FSH – LH would be high and FSH midrange or low
• c.Fasting glucose and/or OGTT – insulin resistance is part of PCOS
• d.Sex hormone binding globulin (SHBG) – often low in PCOS
• e.Fasting lipid levels – triglycerides and LDL often elevated in PCOS
• f.To rule out other disorders as suspected – thyroid function tests, prolactin levels, pelvic ultrasound, karyotype (Turner’s), serum 17-hydroxyprogesterone levels (for 21-OH CAH), 24hr urine for cortisol (Cushing’s), serum IGF-1 (acromegaly)
• g.dehydroepiandrosterone-sulfate (DHEA-S) – may be normal or slightly high in PCOS, often very elevated in ovarian/adrenal tumours
• h.Any female with oligo or amenorrhea should have a beta-hCG to rule out pregnancy

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