Can You Test for PCOS at Home?

Polycystic ovary syndrome (PCOS) is a hormonal disorder that affects 10 percent of women of childbearing age. It's a poorly understood condition that can be difficult to diagnose because some of the main symptoms, such as heavy menstrual bleeding and irregular cycles, can also be caused by conditions such as pelvic inflammatory disease (PID) or uterine fibroids.

Women also have a history of their pain and discomfort being overlooked, mismanaged and misdiagnosed. Almost 34 percent of women had to wait more than two years for a PCOS diagnosis and 47 percent saw at least three doctors in the process, according to a survey published in 2017 in the Journal of Clinical Endocrinology & Metabolism.

An earlier diagnosis would be beneficial for many women struggling with infertility and other devastating symptoms. Some companies claim to have created a quicker and less invasive solution with at-home testing kits for PCOS. But are these tests reliable and safe to use?

Most of these home testing kits involve taking a finger-prick blood sample, which is then used to measure your hormone levels. Typically, the kit tests for the following:

• Testosterone
• Cortisol
• Sex hormone binding globulin (SHBG)
• Free androgen index (FAI)
• Follicle-stimulating hormone (FSH)
• Luteinizing hormone (LH)

Elevated levels of testosterone, FAI, LH and cortisol could indicate that you have PCOS.

These tests usually advise you to take the blood sample first thing in the morning, during a fasting stage, although water is permitted. If you have a regular period, you should take the sample on days three to five of your menstrual cycle.

If you have irregular periods, this can make testing more difficult. Some companies advise you to test in the morning, between Monday and Friday, at any point during your cycle. You will likely need a follow-up with a healthcare professional to discuss your results.

While testing kits can provide some information about your hormone levels, they are not sufficient to diagnose PCOS.

The accuracy of the results is unclear. Ana Maria Kausel, M.D., an endocrinologist in Albany, New York, and co-founder of Anzara Health, said the accuracy depends on what part of the cycle the patient is checking and other circumstances.

"We check for testosterone and SHBG, but some women have PCOS with normal testosterone levels," Kausel said. "LH and FSH used to be checked but they are not in the guidelines anymore. SHBG can be elevated and decreased in a lot of circumstances, so it has to be interpreted in combination with other hormones and clinical symptoms."

While companies acknowledge that their at-home tests cannot diagnose PCOS, they do promise the highest standards of testing. They have nurses available to interpret results and provide advice on the next steps, but an at-home test should only be seen as an initial test.

Your results may or may not be accurate and a follow-up appointment with your doctor is essential.

Tania Adib, M.D., M.B.B.S., consultant gynecologist at the Medical Chambers Kensington in London, warned that these at-home tests are basic and present the possibility of misdiagnosis. The test can't explain the many reasons a patient is not getting their periods because it doesn't look at the thyroid, adrenals, prolactin and other known causes of missed periods, according to Adib.

If a woman hasn't had her periods for six months, you don't know where she is in her cycle, which means the test could give misleading information. Another issue Adib has with these tests is they don't test for progesterone, which is a very important hormone to check when investigating PCOS.

Kausel expressed a similar concern regarding home tests: "Normal women have testosterone, LH, FSH peaks at some point in the cycle. If they happen to check at that point, they might get false-positive results and be self-misdiagnosed.

"Cortisol is a very complicated hormone to test, and patients often come with alarming results from at-home tests when it was just normal, physiological cortisol response," Kausel said. "I strongly discourage testing for cortisol at home."

You might be under the impression that PCOS home testing kits are convenient and can be used by all women, but that's not the case. Many of these tests are not suitable for women who are younger than age 20, are taking hormonal contraception, have a bleeding disorder or are taking any medications that can increase the risk of bleeding.

Various medications and birth control can interfere with test results and cause a false diagnosis.

Regardless of whether you use an at-home test or not, you will still need further testing to make a PCOS diagnosis. Adib said it's important to get a referral to see a gynecologist who can investigate further. They may take a blood test and blood pressure, perform a physical and pelvic exam, and send you for an ultrasound.

"The best indicator that something is not right is symptoms," Kausel said.

If a woman who is not taking contraceptives is missing periods or experiencing excess facial hair, acne, hair loss, darker skinfolds or weight problems, then an investigation is necessary. If your doctor doesn't take your concerns seriously, ask to be referred to a professional who will listen.