PCOS Blood Tests: The Panel to Ask For and How to Read It

What tests diagnose PCOS?

No single blood test diagnoses PCOS. The 2023 international evidence-based guideline confirms it only when a patient meets two of three criteria first set out in a 2003 consensus workshop and still in use today — read the full Rotterdam criteria for how each one is defined: irregular or absent ovulation, clinical or biochemical signs of excess androgens, and polycystic ovaries on ultrasound (or, in adults, an elevated AMH level as an accepted substitute for the scan). Blood work does three jobs inside that framework, as one part of a full PCOS diagnostic work-up: it measures whether androgens are actually elevated, it checks the hormones that drive ovulation, and it rules out three conditions that mimic PCOS on the surface — thyroid disease, high prolactin, and non-classic congenital adrenal hyperplasia.

Note: in May 2026, PCOS was renamed polyendocrine metabolic ovarian syndrome, or PMOS, by a global consensus of more than 50 organisations. The tests below and the criteria behind them did not change — only the label on the diagnosis did. This article uses PCOS, since that is still the term most readers search.

The core PCOS blood panel, test by test

A standard PCOS work-up draws eight distinct values from one blood sample, each checked against a reference range that varies by lab and by which method processed the sample — a point worth holding onto before you read the table below.

*These are commonly published reference intervals, not universal ones. Every lab prints its own range on your report — compare your result to that printed range, not to a number from an article.

Alongside this hormone panel, the Androgen Excess Society recommends a 2-hour, 75-gram oral glucose tolerance test at diagnosis, because fasting glucose alone misses a meaningful share of the women with PCOS who already have impaired glucose tolerance. A fasting lipid panel usually rides along on the same draw, since low HDL and raised triglycerides are a common pattern alongside the hormone picture.

Labcorp vs Quest PCOS panel: does it actually differ?

Labcorp and Quest test the same core hormones, but the assay method behind your number — not the company name on the report — is what actually changes the result you get back. A 2007 Endocrine Society position statement found that direct immunoassays for testosterone are frequently inaccurate at the low concentrations typical of women, which is exactly the range most PCOS results fall into. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) is the method that statement recommends instead, and both major lab networks offer it — but it is not always the default test your clinician’s order form selects.

What to actually ask for, at either lab: a comprehensive androgen panel that includes SHBG so free testosterone can be calculated, and — if your total testosterone comes back borderline on a standard immunoassay — a repeat run by LC-MS/MS before anyone concludes your androgens are normal. The panel name on the requisition form (“PCOS panel,” “androgen panel,” “hyperandrogenism work-up”) differs by clinic and by which lab menu the ordering provider is using; the underlying hormones you need tested do not.

Reading your numbers by phenotype

Which values come back abnormal on this panel usually maps to which of the four Rotterdam phenotypes you have, not to one fixed pattern every diagnosed person shares. In the insulin-resistant phenotypes, SHBG is often driven down by circulating insulin, which pushes free testosterone and the free androgen index up even when total testosterone looks unremarkable, and the OGTT frequently shows impaired glucose tolerance. In the lean, hyperandrogenic phenotype, the glucose and insulin values are usually ordinary, and the androgen elevation is often driven more by pituitary LH output than by insulin. In the ovulatory-but-hyperandrogenic phenotype, androgens sit above range while cycles stay regular and glucose handling is normal. In the fourth, non-hyperandrogenic phenotype, every hormone on this panel can come back inside range — the diagnosis in that case rests on the ultrasound or AMH plus the cycle history, not on this blood work at all.

What this panel cannot tell you

Two things distort this panel enough to be worth planning around before you book the draw. First, hormonal contraception suppresses LH, FSH and ovarian androgen output while raising SHBG — so a panel run while on the combined pill reads artificially reassuring on every value this article covers, not just testosterone. Many clinicians will ask you to retest after stopping hormonal contraception, under their guidance, before concluding the picture is normal. Second, a single blood draw captures one moment in a hormone system that pulses throughout the day and shifts across the menstrual cycle; a borderline result on one morning is not the same evidence as a pattern confirmed on a second draw.

Who this doesn’t work for

This panel will not confirm PCOS in someone whose only Rotterdam criterion is polycystic ovaries on ultrasound with entirely normal cycles and no androgen excess — that pattern alone does not meet the two-of-three definition, blood work or not. It also will not settle the question for someone currently on hormonal contraception, recently pregnant, or breastfeeding, since all three states shift this exact panel independent of PCOS. And it cannot substitute for ruling out thyroid disease, high prolactin or non-classic adrenal hyperplasia as the actual cause of irregular cycles — which is precisely why TSH, prolactin and 17-OH progesterone are drawn alongside the androgens rather than skipped.