Blood tests for PCOS
For people with PCOS (also called PMOS), and anyone being checked for it because of irregular periods, extra hair growth or acne.
12 tests explainedAI-verified against cited sources. Awaiting expert reviewLast reviewed 2026-10-19
Blood tests for PCOS do two jobs. Early on, they help show raised androgens (male-type hormones) and rule out other conditions that look similar. After that, the focus turns to long-term health: blood sugar and cholesterol, which guidelines suggest checking at the start and then over time.
The tests that matter most
Most important first. Each one links to its full page, where the note for this group sits near the top.
Testosterone, Total
Total testosterone is the first blood test for raised androgens in PCOS. The 2023 international guideline asks labs to use mass spectrometry (LC-MS/MS) rather than direct immunoassays, which have limited accuracy for this.
Source: Journal of Clinical Endocrinology and Metabolism (2023)
- Men, 20+
- 264–916 ng/dL
- Men, 18–19
- 150–785 ng/dL
Testosterone, Free
The guideline uses free testosterone alongside total testosterone. It can be calculated, including as the free androgen index, or measured by equilibrium dialysis.
Source: Journal of Clinical Endocrinology and Metabolism (2023)
- Men, 18+
- 47–244 pg/mL
- Women, 18–30
- 0.8–7.4 pg/mL
Sex Hormone-Binding Globulin (SHBG)
The combined pill raises SHBG, a protein that binds testosterone, and lowers the body's own androgen production. That is why the guideline says androgen results are very hard to read while taking it.
Source: Journal of Clinical Endocrinology and Metabolism (2023)
- Men, 20–49
- 16.5–55.9 nmol/L
- Men, 50+
- 19.3–76.4 nmol/L
DHEA Sulfate (DHEA-S)
If testosterone and free testosterone aren't raised, the guideline says DHEA-S and androstenedione could be checked, ideally by LC-MS/MS. They are less specific for PCOS, and DHEA-S falls with age.
Source: Journal of Clinical Endocrinology and Metabolism (2023)
- Men, 20–24
- 164.3–530.5 µg/dL
- Women, 20–24
- 110–431.7 µg/dL
Anti-Mullerian Hormone (AMH)
In adults, the 2023 guideline allows AMH as an alternative to an ovarian ultrasound for one of the PCOS criteria. It isn't needed when periods are irregular and androgens are raised, it isn't meant as a single test, and it isn't used in teens yet.
Source: Journal of Clinical Endocrinology and Metabolism (2023)
- Women, 20–24
- 1.2–12 ng/mL
- Women, 25–29
- 0.89–9.9 ng/mL
Glucose, OGTT 2-Hour
The guideline calls the 75 g oral glucose tolerance test (OGTT) the most accurate way to check blood sugar in PCOS, at any body weight. It also suggests one when planning pregnancy or fertility treatment.
Source: Journal of Clinical Endocrinology and Metabolism (2023)
- Usual adult range
- up to 139 mg/dL
Hemoglobin A1c (HbA1c)
If an OGTT isn't possible, the guideline says A1c or fasting glucose could be used, though they are noticeably less accurate in PCOS. Blood sugar is checked at the start and then every 1 to 3 years, depending on other risk factors.
Source: Journal of Clinical Endocrinology and Metabolism (2023)
- Usual adult range
- 4.8–5.6 %
LDL Cholesterol
The guideline suggests a full lipid profile (cholesterol, LDL, HDL and triglycerides) for everyone with PCOS at the start, at any age or weight. How often to repeat it depends on the results and other heart risk factors.
Source: Journal of Clinical Endocrinology and Metabolism (2023)
- Usual adult range
- up to 99 mg/dL
TSH (Thyroid Stimulating Hormone)
The guideline's checklist includes ruling out other causes of similar symptoms. TSH, the main thyroid test, is one of the tests it lists for this.
Source: Journal of Clinical Endocrinology and Metabolism (2023)
- Usual adult range
- 0.45–4.5 mIU/L
Prolactin
Prolactin is on the guideline's short list of tests used to rule out other causes of PCOS-like symptoms, along with TSH, 17-OHP and FSH.
Source: Journal of Clinical Endocrinology and Metabolism (2023)
- Men, 10+
- 2.1–17.7 ng/mL
- Women, 10+
- 2.8–29.2 ng/mL
17-Hydroxyprogesterone (17-OHP)
17-OHP helps check for nonclassic congenital adrenal hyperplasia, a mild form of an adrenal condition people are born with that can cause extra androgens. The PCOS guideline lists 17-OHP among the tests that rule out other causes.
Sources: Endocrine Society (2018) and Journal of Clinical Endocrinology and Metabolism (2023)
- Men, 18+
- up to 220 ng/dL
- Women, 18+
- up to 207 ng/dL
HOMA-IR
Insulin resistance is a key part of PCOS, but the 2023 guideline says the measures available today, including insulin tests, are inaccurate and not recommended in routine care. It prefers an OGTT for checking blood sugar.
Source: Journal of Clinical Endocrinology and Metabolism (2023)
Ranges shown are the usual adult ranges labs print. The range on your own report is the one your result is judged against.
Getting results you can compare
- The combined pill makes androgen results hard to read. If androgen testing is essential, the guideline describes a break from the pill of at least 3 months first, with other contraception in the meantime. That's a decision to make with your clinician.
Source: Journal of Clinical Endocrinology and Metabolism (2023)
- Androgen ranges vary widely between test methods and labs, the guideline notes, so results from different labs can be hard to compare.
Source: Journal of Clinical Endocrinology and Metabolism (2023)
- AMH can be lower with current or recent use of the pill, and it varies with age, body weight and cycle day, the guideline notes.
Source: Journal of Clinical Endocrinology and Metabolism (2023)
- 17-OHP is best drawn early in the morning, before 8 a.m., and for people with periods, early in the cycle, in the days after a period starts, the Endocrine Society says. A random sample can miss a raised level.
Source: Endocrine Society (2018)
Good to know
- Repeating androgen tests over time has a limited role for adults once PCOS is established, the guideline says. Blood sugar and cholesterol are the tests that carry on over the years.
Source: Journal of Clinical Endocrinology and Metabolism (2023)
- If you're planning a pregnancy, the guideline suggests an OGTT beforehand or at the first prenatal visit, and offering one to everyone with PCOS at 24 to 28 weeks, because high blood sugar in pregnancy is more common with PCOS.
Source: Journal of Clinical Endocrinology and Metabolism (2023)
- In 2026 a global consensus chose a new name for PCOS, polyendocrine metabolic ovarian syndrome, because the old name wrongly points to cysts and hides the hormone and metabolic sides of the condition. A transition period is under way, so reports may use either name.
Source: The Lancet (2026)
Questions you could ask
- Were my testosterone results measured by mass spectrometry?
- Would an oral glucose tolerance test tell us more than my A1c?
- How often should we recheck my blood sugar and cholesterol?
- Does the pill or any other medicine change how we read these results?
- Which tests have been used to rule out other causes of my symptoms?
Sources
- Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome, Journal of Clinical Endocrinology and Metabolism (2023)
- Congenital Adrenal Hyperplasia Due to Steroid 21-Hydroxylase Deficiency: An Endocrine Society Clinical Practice Guideline, Endocrine Society (2018)
- Polyendocrine metabolic ovarian syndrome, the new name for polycystic ovary syndrome: a multistep global consensus process, The Lancet (2026)
AI-verified against cited sources. Awaiting expert review. Last reviewed 2026-10-19. How we build and check these pages.
Educational information, not medical advice. Blood Test Tracker doesn’t diagnose or treat, and it doesn’t replace your clinician. Talk with your clinician before changing medications, supplements or care.