PCOS in Indian Women: The Complete Hormone Test Panel You Actually Need

Quick answer: PCOS (Polycystic Ovary Syndrome) is diagnosed when at least two of three features are present: irregular or absent ovulation (irregular periods), signs of high androgens (acne, excess facial or body hair, scalp hair thinning, or high testosterone on a blood test), and polycystic ovaries on ultrasound — after other causes are ruled out. A typical PCOS blood panel includes total testosterone (and sometimes free testosterone or SHBG), LH and FSH, prolactin, TSH, 17-OH progesterone, AMH (as advised), and metabolic tests — fasting sugar, HbA1c, fasting insulin and lipid profile. Hormone tests are usually done on day 2–5 of the cycle.

PCOS is one of the most common hormonal conditions in Indian women of reproductive age. It's also one of the most misunderstood — often reduced to "cysts on the ovaries" or "weight gain". In reality, PCOS is a whole-body condition affecting periods, skin, hair, fertility, mood and long-term metabolic health.

Symptoms of PCOS

• Irregular, infrequent or absent periods
• Acne, especially along the jaw
• Excess hair on the face, chest or abdomen (hirsutism)
• Thinning hair on the scalp
• Weight gain, especially around the abdomen, and difficulty losing weight
• Dark, velvety skin patches on the neck or armpits (a sign of insulin resistance)
• Difficulty conceiving
• Mood changes, anxiety or low mood

Not every woman with PCOS has all of these — and many lean women have PCOS too.

The PCOS Test Panel Explained

Hormone Tests

• Total testosterone: often mildly raised in PCOS. Free testosterone or the free androgen index (using SHBG) can be more sensitive
• LH and FSH: an LH that is high relative to FSH is common in PCOS, though not required for diagnosis
• Prolactin: high prolactin can cause irregular periods and must be ruled out
• TSH: thyroid disorders can mimic PCOS — see thyroid test explained
• 17-OH progesterone: screens for non-classic congenital adrenal hyperplasia, a condition that looks like PCOS
• AMH (Anti-Müllerian Hormone): often high in PCOS; also used in fertility assessment, as advised
• DHEA-S: an adrenal androgen, checked in some cases

Metabolic Tests

PCOS increases the risk of diabetes, fatty liver and heart disease — even in young and lean women.

• Fasting blood sugar and HbA1c — see HbA1c explained
• OGTT — the most sensitive test for glucose problems in PCOS, as advised
• Fasting insulin — to assess insulin resistance
• Lipid profile — see lipid profile guide
• Liver function test — fatty liver is common. See fatty liver

Other Tests That May Help

• Vitamin D and vitamin B12 (especially if on metformin)
• CBC and ferritin if periods are heavy
• Pelvic ultrasound to look at the ovaries and uterine lining

When to Test During Your Cycle

• LH, FSH and testosterone are usually tested on day 2–5 of a natural period (day 1 is the first day of bleeding)
• If periods are absent, tests may be done on any day, sometimes after a pregnancy test
• Fasting (10–12 hours) is needed for fasting sugar, insulin and lipids
• If you take hormonal pills, they affect results — ask your doctor whether to test before starting or after a break

PCOS in Teenagers

Irregular periods are common for the first two to three years after periods start, so PCOS is diagnosed more cautiously in teenagers. Persistent irregularity with acne or hair growth should still be evaluated.

Managing PCOS — and What to Retest

• Lifestyle: even 5–10% weight loss can restore regular periods and improve insulin resistance
• Exercise: both aerobic and strength training improve insulin sensitivity
• Diet: fewer refined carbs and sugary drinks, more protein and fibre
• Medical treatment: as prescribed — for cycle regulation, skin and hair symptoms, insulin resistance or fertility
• Retesting: HbA1c/fasting sugar and lipid profile every year, or more often if abnormal

Frequently Asked Questions

Which blood tests are done for PCOS?

Common tests include total testosterone, LH, FSH, prolactin, TSH, 17-OH progesterone, AMH in some cases, and metabolic tests such as fasting sugar, HbA1c, fasting insulin and lipid profile.

On which day of the period should PCOS tests be done?

Hormone tests like LH, FSH and testosterone are usually done on day 2 to 5 of the menstrual cycle.

Can PCOS be diagnosed with a blood test alone?

No. PCOS is diagnosed using a combination of symptoms, blood tests and sometimes ultrasound, after ruling out other conditions.

Can lean women have PCOS?

Yes. Many women with PCOS have a normal weight. They still benefit from metabolic screening.

Does PCOS increase diabetes risk?

Yes. Women with PCOS have a higher risk of pre-diabetes and type 2 diabetes, so regular HbA1c or fasting sugar tests are recommended.

Do I need to fast for PCOS tests?

Fasting for 10–12 hours is needed if fasting sugar, insulin or lipid profile are included. Hormone tests alone don't require fasting.

Book PCOS Tests in Gurugram

Call +91 92663 33711 with your gynaecologist's prescription and we'll schedule your hormone and metabolic tests for the right day of your cycle — at our Sector 67 lab or at home. See also our essential tests for women and immunology and hormone tests.

This article is for general information only. Please consult your gynaecologist or endocrinologist for diagnosis and treatment.