Women's Health

PCOD / PCOS: Understanding Your Hormone Tests

Name: PCOD/PCOS: What Blood Tests Show & What Results Mean
Creator: Suman Konda
Published: 2026-07-05

Polycystic Ovary Syndrome (PCOS) affects an estimated 8–13% of women of reproductive age worldwide. Here's what the blood tests used to diagnose and manage it actually measure: and what your results mean.

Written by Suman Konda, PharmD, Clinical Pharmacist · Based on peer-reviewed sources · Editorial policy · Not medical advice

Last updated: 01 August 2026 · How we check our content

What is PCOD/PCOS?

PCOS (Polycystic Ovary Syndrome) is a hormonal disorder where the ovaries produce excess androgens (male hormones), causing irregular periods, excess facial/body hair (hirsutism), acne, hair thinning and difficulty conceiving. It is also strongly linked to insulin resistance, weight gain and long-term risk of Type 2 diabetes and heart disease. PCOD (Polycystic Ovarian Disease) is an older term often used interchangeably, though technically they're slightly different.

Blood Tests Used in PCOS Diagnosis

Test	What it measures	Typical finding in PCOS
LH (Luteinising Hormone)	Ovulation trigger hormone	Elevated (LH:FSH ratio >2:1)
FSH (Follicle Stimulating Hormone)	Egg maturation hormone	Normal or low
LH:FSH Ratio	Balance of reproductive hormones	>2:1 or >3:1 suggests PCOS
Total Testosterone	Main male hormone	Elevated (above 0.6 ng/mL in women)
DHEA-S	Adrenal androgen	May be elevated
Prolactin	Milk hormone	Normal (rules out other causes)
AMH (Anti-Müllerian Hormone)	Ovarian reserve / follicle count	Elevated in PCOS
Fasting Insulin	Insulin resistance marker	Elevated (>15 µIU/mL fasting)
Fasting Blood Sugar / HbA1c	Diabetes/prediabetes screen	Often prediabetic
TSH (Thyroid)	Rules out thyroid as cause	Normal (to rule out hypothyroidism)

What does a high LH:FSH ratio mean in PCOS?

LH:FSH ratio above 2:1

Normally LH and FSH are roughly equal (1:1). In PCOS, LH is persistently elevated relative to FSH, disrupting the normal ovulation cycle. This ratio is supportive of PCOS but not diagnostic on its own. It must be combined with symptoms and an ultrasound. Note: this ratio is less reliable if taken during the LH surge at mid-cycle.

What does high AMH mean?

AMH above 5 ng/mL: High ovarian reserve, PCOS marker

AMH (Anti-Müllerian Hormone) is produced by follicles in the ovaries. In PCOS, multiple small follicles are present (the "cysts"), causing AMH to be 2–3 times higher than normal. High AMH in the context of irregular periods and androgen excess strongly supports PCOS. AMH is now used as a more reliable marker than the LH:FSH ratio in many centres.

Questions to ask your doctor

Do I have insulin resistance and should I start metformin?
Do I need a pelvic ultrasound to count follicles?
Is my PCOS affecting my fertility?
What lifestyle changes will have the most impact on my hormone levels?

References

The clinical information on this page is drawn from peer-reviewed sources indexed by the US National Library of Medicine. Links go to the source so you can read it yourself.

Hirsutism. In: StatPearls. Treasure Island (FL): StatPearls Publishing. NCBI Bookshelf NBK470417