PCOS tests: which blood tests doctors order and which fit
There is no single PCOS test. Polycystic ovary syndrome is diagnosed from a pattern: your cycles, signs of high androgens (male-type hormones), and sometimes an ultrasound. Blood tests play two roles. They can show whether androgens are high, and they can help rule out other conditions that look like PCOS.
This page covers what the international guideline says and which of the tests sold here match it. It does not replace a diagnosis from a clinician.
Free and total testosterone
Both numbers on one order, for less than the $108 they cost separately.
$99
See this test at HealthLabsPrice checked October 2026. Not available in ND, RI, NY, NJ, MD and HI. We earn a commission on sales.
How PCOS is diagnosed
The 2023 international guideline says an adult needs two of these three:
- Irregular cycles or ovulation problems. For someone three or more years past her first period and not yet in perimenopause, the guideline counts cycles shorter than 21 days, longer than 35 days, or fewer than 8 a year as irregular.
- High androgens. This can be a sign you can see, such as excess hair growth, or a blood test result.
- Polycystic ovaries on ultrasound. In adults, a blood test for AMH can be used instead of the ultrasound. The guideline says not to do both, and not to use AMH as a single test for PCOS.
Two details matter for what you order:
- If you have irregular cycles and high androgens, the guideline says an ultrasound or an AMH test is not needed to make the diagnosis.
- In teenagers, the guideline requires both irregular cycles and high androgens, and does not recommend ultrasound or AMH.
MedlinePlus describes the same pattern: PCOS usually means at least two of not ovulating, high androgens, and growths on the ovaries.
Which blood tests are typically ordered
Here is where each test fits, with the lowest-priced option first. None of these is a PCOS test or a PCOS panel. Each one answers a single question in the work-up.
- Total testosteroneTotal testosterone only. The lower-priced start $49 See this test at HealthLabs
- ProlactinOne of the labs used to rule out other causes $59 See this test at HealthLabs
- FSH onlyAnother rule-out lab, FSH only $49 See this test at HealthLabs
- FSH and LHFSH with LH, which the guideline also names for low body fat or intense exercise $59 See this test at HealthLabs
- ProgesteroneTo check whether you ovulated, if your cycles are regular $45 See this test at HealthLabs
- AMHCan stand in for ultrasound in adults. Not a stand-alone test $89 See this test at HealthLabs
- DHEA sulfateAn add-on only if testosterone is not high $169 See this test at HealthLabs
Sold by HealthLabs. Prices checked October 2026. Not available in ND, RI, NY, NJ, MD and HI. We earn a commission on sales.
Testosterone: total and free
This is the test that speaks to the androgen part of the diagnosis. The guideline says clinicians should use total and free testosterone to assess high androgens, and that free testosterone can be estimated by a calculation called the free androgen index. The one-order option here gives you both total and free testosterone. Total testosterone on its own costs less and gives you the first number.
The guideline says the blood test is most useful when you have few or no visible signs of high androgens. It also says that excess hair growth on its own should be considered a predictor of high androgens and PCOS in adults. Acne or scalp hair thinning without excess hair growth are weaker predictors.
Labs that rule out other causes
Other conditions can cause irregular periods and signs of high androgens. The guideline’s diagnostic chart lists these labs for excluding them: TSH, prolactin, 17-hydroxyprogesterone and FSH. Where low body fat or intense exercise is the concern, it names LH and FSH.
Prolactin and FSH (or FSH with LH) are on the list above. TSH and 17-hydroxyprogesterone are not, so a clinician would need to order those. Read more on the prolactin test and the FSH test.
AMH and progesterone
AMH can replace the ultrasound for the “polycystic ovaries” feature in adults, but only within the guideline’s pattern, and not as a single test. If you already have irregular cycles and high androgens, you do not need it for the diagnosis. The guideline also says AMH can be lower on the combined pill and can vary across the cycle. See the AMH test.
Ovulation problems can still happen with regular cycles. The guideline says a serum progesterone level can be used to confirm that you did not ovulate. Timing matters, so read when to test progesterone first.
DHEA-S
If testosterone is not high, the guideline says a clinician could consider DHEA-S and androstenedione, with the caveat that they are less specific. DHEA-S also falls with age. It is a later step, not a starting point.
What can change your testosterone results
The guideline makes three points a lab report will not tell you:
- The combined birth control pill. It raises SHBG, a protein that binds testosterone, and lowers androgen production. The guideline calls it very difficult to judge androgens in women on the pill. If measuring them is essential, it says the pill would need to be stopped for at least 3 months, with other contraception in the meantime. That is a decision for you and your clinician. Do not stop a medicine on your own.
- Reference ranges vary. The guideline notes that ranges differ widely between methods and labs. Use the range printed on your own report.
- Repeat testing has a limited role. For adults, the guideline says repeated androgen measures for ongoing assessment have a limited role.
If you also want cholesterol and blood sugar
Once PCOS is diagnosed, the guideline says everyone with it should have a lipid profile and a blood sugar (glycaemic) assessment at diagnosis. It names the 75-g oral glucose tolerance test as the most accurate way to check blood sugar, and says fasting glucose or HbA1c are less accurate.
Sold by HealthLabs. Prices checked October 2026. Not available in ND, RI, NY, NJ, MD and HI. We earn a commission on sales.
The seller’s page for this panel lists total testosterone, estradiol, a lipid panel and a metabolic panel that includes glucose, among other markers. It does not list prolactin, FSH or LH, and it is not a PCOS panel. The seller’s page says to fast for at least 8 hours. It does not replace a glucose tolerance test. Check whether a single testosterone order answers your question first.
When to see a clinician
Take your cycle history, any hair or acne changes and your results to a clinician. They put the pieces together, and they are the ones who can diagnose PCOS.
See one sooner if hair growth or other androgen signs started recently or are getting worse quickly. The guideline says new-onset, severe or fast-worsening signs need further investigation to rule out an androgen-producing tumour. It also says that when androgens are far above the lab’s range, causes other than PCOS should be considered.
Free and total testosterone
$99
See this test at HealthLabsPrice checked October 2026. Not available in ND, RI, NY, NJ, MD and HI. We earn a commission on sales.
Keep reading
- Testosterone test for women: which one to order
Women make testosterone too. See what the test measures, total versus free, a published range for women, and which blood test is the lowest-priced fit.
- High testosterone in women: what a high result can mean
A high testosterone result in a woman can have several causes, from PCOS to adrenal or ovarian conditions. See what it can mean and when to see a clinician.
- Prolactin test for women: what it checks and how to prepare
A prolactin test measures a pituitary hormone linked to periods, fertility and milk production. See when it is ordered, how to prepare and a published range.
- High prolactin in women: causes and what a high result means
High prolactin has many possible causes, from medicines to a pituitary tumor. See what a high result can mean, what happens next and when to see a clinician.