Last updated: 11 November 2026 · Medically reviewed by Dr. Neem, HealthDeliver’s lead doctor
Quick answer
Polycystic ovary syndrome (PCOS) is a common hormone condition that affects how the ovaries work. It often causes irregular periods, higher levels of male-type hormones (androgens) and, in some women, many small follicles on the ovaries.
Doctors diagnose PCOS when you have at least two of three key signs and other causes have been ruled out, usually with blood tests and sometimes an ultrasound. At HealthDeliver, hormone testing starts from ฿3,990.
Key Takeaways
- PCOS affects an estimated 6–13% of women of reproductive age, and up to 70% of women with PCOS are undiagnosed (WHO).
- The most common signs are irregular or missed periods, excess facial or body hair, acne and difficulty getting pregnant.
- Diagnosis uses the Rotterdam criteria: two out of three of irregular ovulation, high androgens, or polycystic ovaries on ultrasound (or a high AMH level in adults).
- Blood tests check hormones (testosterone, SHBG, LH, FSH) and rule out thyroid and prolactin problems. They also check blood sugar and cholesterol, because PCOS raises the risk of type 2 diabetes.
- There is no cure, but symptoms can be managed with lifestyle changes, medicines and, if needed, fertility treatment.
- At HealthDeliver in Bangkok, a Sex Hormones Assessment (7 markers) costs ฿3,990, and a doctor’s consultation costs ฿1,250 in clinic or ฿700 online.
What Is PCOS?
PCOS is a hormonal and metabolic condition. Your ovaries produce more androgens (such as testosterone) than usual, and ovulation, the release of an egg each month, happens irregularly or not at all.
Despite the name, you don’t need cysts to have PCOS. The “cysts” are actually small, immature follicles. Many women with PCOS have normal-looking ovaries, and some women without PCOS have polycystic-looking ovaries.
PCOS is also linked to insulin resistance, where the body needs more insulin to keep blood sugar normal. That’s why it affects weight, skin and long-term heart and diabetes risk, not just periods.
The exact cause isn’t known. PCOS runs in families, and genetics, insulin resistance and inflammation all seem to play a part.
PCOS Symptoms: What to Look For
Symptoms usually start in the late teens or early twenties, but many women aren’t diagnosed until they try to get pregnant. You may have only one or two of these.
| Symptom | What it usually means |
|---|---|
| Periods more than 35 days apart, fewer than 8 a year, or none at all | You aren’t ovulating regularly |
| Excess hair on the face, chest, back or stomach (hirsutism) | Raised androgen levels |
| Acne, especially along the jaw, that lasts past your teens | Raised androgen levels |
| Thinning hair on the scalp | Raised androgen levels |
| Weight gain, especially around the waist, and finding it hard to lose | Insulin resistance |
| Dark, velvety skin in the neck, armpits or groin (acanthosis nigricans) | Insulin resistance |
| Difficulty getting pregnant | Irregular or absent ovulation |
| Low mood, anxiety or poor sleep | PCOS is linked to higher rates of depression, anxiety and sleep apnoea |
When to see a doctor: book a consultation if your periods are regularly more than 35 days apart, have stopped for 3 months or more (and you aren’t pregnant), or if you have new excess hair growth, persistent acne or trouble conceiving after 12 months of trying (6 months if you’re over 35). Seek urgent care for very heavy bleeding or severe pelvic pain.
How PCOS Is Diagnosed: The Rotterdam Criteria
Doctors use the Rotterdam criteria, which the 2023 International PCOS Guideline still recommends. You’re diagnosed with PCOS if you have at least two of these three:
- Irregular or absent ovulation: usually shown by irregular periods.
- High androgens: either signs you can see (excess hair, acne) or high levels in a blood test.
- Polycystic ovaries: on an ultrasound scan, or, for adults, a high AMH (anti-Müllerian hormone) blood level instead of a scan.
The doctor also needs to rule out other conditions that look like PCOS, such as thyroid disease, high prolactin and a rare adrenal condition (non-classic congenital adrenal hyperplasia).
If you have irregular periods and high androgens, you don’t need an ultrasound to be diagnosed. For teenagers, ultrasound and AMH aren’t used within 8 years of the first period, because many young women’s ovaries naturally look “polycystic”.
Which Blood Tests Diagnose PCOS?
No single blood test confirms PCOS. Your doctor uses a panel to check androgens, exclude other causes and screen for metabolic risks.
| Test | What it checks | When to test |
|---|---|---|
| Total testosterone | The main androgen; high levels support a PCOS diagnosis | Any day if periods are irregular; days 2–5 if regular |
| SHBG | Used with testosterone to calculate free testosterone (the active form). Low SHBG is common in PCOS. | Same sample as testosterone |
| DHEAS | An androgen from the adrenal glands; helps rule out adrenal causes | Any day |
| LH and FSH | Pituitary hormones that control ovulation; rule out other causes of missed periods | Days 2–5 of your cycle, if you have one |
| Estradiol and progesterone | Estrogen level; a mid-luteal progesterone level (about day 21 of a 28-day cycle) shows whether you ovulated | Progesterone 7 days before your expected period |
| TSH | Thyroid function; an under- or overactive thyroid can cause irregular periods | Any day |
| Prolactin | Rules out high prolactin, another cause of missed periods | Any day, ideally in the morning |
| AMH | Can be used instead of an ultrasound in adults | Any day |
| Fasting glucose, HbA1c or a glucose tolerance test | Screens for prediabetes and diabetes | After an 8–12 hour fast |
| Cholesterol and triglycerides | Heart and metabolic risk | After fasting |
Before your test:
- If you take the contraceptive pill, androgen results won’t be accurate. Doctors usually advise stopping it for about 3 months before testing. Don’t stop it without talking to a doctor first.
- Fast for 8–12 hours if glucose or cholesterol is being checked (water is fine). See our guide to fasting before a blood test.
- Morning tests (8–10am) give the most reliable hormone results.
PCOS Treatment Options
Treatment depends on your symptoms and goals, such as regular periods, clearer skin, weight management or pregnancy. Most women use a combination.
| Treatment | What it helps | Notes |
|---|---|---|
| Lifestyle changes (diet, exercise, sleep) | Periods, insulin resistance, weight, mood | Losing 5–10% of body weight can restart ovulation in many women with excess weight |
| Combined oral contraceptive pill | Regulates periods; reduces acne and hair growth | First-line for women not trying to conceive; protects the womb lining |
| Metformin | Insulin resistance, weight, cycle regularity | Often combined with the pill or lifestyle changes; may cause stomach upset at first |
| Anti-androgens (e.g. spironolactone) | Excess hair, acne, scalp hair loss | Must be used with reliable contraception |
| Letrozole | Ovulation for women trying to conceive | First-line fertility medicine for PCOS; prescribed and monitored by a doctor |
| Weight-loss medicines (e.g. GLP-1 medicines such as semaglutide) | Weight and blood sugar | Can be considered alongside lifestyle changes for women with obesity. Not a PCOS-specific treatment, and must be stopped before trying to conceive. |
| Skin and hair treatments | Hirsutism and acne | Laser hair removal and topical treatments work alongside medicine |
If you’re not ovulating and aren’t on the pill, your doctor may prescribe progesterone every few months to bring on a bleed. Going a long time without periods can thicken the womb lining and raise the risk of endometrial cancer.
Learn more about weight loss medication in Bangkok and how semaglutide works.
Long-Term Health Risks of PCOS
PCOS is a lifelong condition, so regular check-ups matter even when your symptoms are under control. Women with PCOS have a higher risk of:
- Type 2 diabetes and gestational diabetes: the guideline recommends checking your blood sugar every 1–3 years
- High cholesterol and high blood pressure
- Endometrial (womb) cancer, if periods are very infrequent
- Sleep apnoea
- Depression and anxiety
PCOS Testing and Treatment at HealthDeliver Bangkok
You can get tested, diagnosed and treated at any of our three clinics: Asok, Sathorn and Phrom Phong.
| Service | Price |
|---|---|
| Sex Hormones Assessment, 7 markers (estradiol, progesterone, testosterone, DHEAS, SHBG, FSH, LH) | ฿3,990 |
| Healthy Female Essentials, 23 markers (incl. fasting glucose, cholesterol, thyroid, estradiol, progesterone) | ฿9,790 |
| Doctor consultation, in clinic | ฿1,250 |
| Doctor consultation, online | ฿700 |
| Home or hotel blood draw in Bangkok | +฿600 nursing fee |
How it works
- Book online, on WhatsApp or LINE, or call 064 553 9506. Same-day and walk-in appointments are available.
- Have a short pre-test chat with our team so you only take the tests you need, at the right time in your cycle.
- Give your blood sample at the clinic from 8am, or at home from 7am.
- Get your results in 4–5 days and go through them with a doctor who can explain the diagnosis and start treatment.
Clinics are open daily, 08:00–18:30. If you need an ultrasound or specialist care, our doctors will advise you on the next steps.
See all our blood tests in Bangkok, our hormone test options and our women’s health services.
Think you might have PCOS?
Get your hormones tested at our clinics in Asok, Sathorn or Phrom Phong from 08:00, or at home from 07:00. The Sex Hormones Assessment (7 markers) costs ฿3,990, and a doctor’s consultation costs ฿1,250 in clinic or ฿700 online.
FAQs
Can PCOS be cured?
No, PCOS can’t be cured, but it can be managed well. Most women control their symptoms with lifestyle changes and medicine, such as the contraceptive pill, metformin or anti-androgens. Symptoms often change with age, weight and pregnancy, so it’s worth reviewing your treatment with a doctor every year.
Can I get pregnant with PCOS?
Yes. Many women with PCOS get pregnant, some naturally and some with help. Irregular ovulation is the main barrier, and medicines such as letrozole can help you ovulate. If you’ve been trying for 12 months (or 6 months if you’re over 35), see a doctor about fertility testing and treatment.
Do I need an ultrasound to be diagnosed with PCOS?
Not always. If you have irregular periods and high androgens, either visible signs or a high blood test result, you meet two of the three Rotterdam criteria without a scan. Adults can sometimes use an AMH blood test instead of an ultrasound. Your doctor will decide which tests you need.
Is PCOS testing accurate if I’m on the pill?
Not fully. The contraceptive pill lowers androgen levels and regulates bleeding, which can hide PCOS. Doctors usually advise stopping the pill for about three months before androgen testing. Don’t stop any medicine without speaking to a doctor first. They can tell you how to do it safely and what contraception to use meanwhile.
Does PCOS cause weight gain?
It can. Insulin resistance, which is common in PCOS, makes weight gain around the waist more likely and weight loss harder. Women of a healthy weight can also have PCOS. Losing 5–10% of your body weight, if you’re overweight, often improves periods, ovulation and blood sugar.
How much does a PCOS blood test cost in Bangkok?
At HealthDeliver, the Sex Hormones Assessment (7 markers) costs 3,990 THB and covers the main PCOS hormones. A wider Healthy Female Essentials panel (23 markers) costs 9,790 THB. A doctor’s consultation to review results costs 1,250 THB in clinic or 700 THB online.
What is the best time in my cycle for a PCOS blood test?
If your periods are regular, test LH, FSH and testosterone on days 2–5 of your cycle. Test progesterone about seven days before your next expected period to check ovulation. If your periods are irregular or absent, you can usually test on any day. Morning samples give the most reliable results.
Can PCOS go away after menopause?
Periods stop at menopause, but PCOS-related risks don’t disappear. Higher androgen levels, insulin resistance and the related risk of diabetes and heart disease can continue. Women with PCOS should keep having regular checks of blood sugar, cholesterol and blood pressure after menopause.
Sources
- World Health Organization. Polycystic ovary syndrome fact sheet.
- Teede HJ et al. International Evidence-based Guideline for the Assessment and Management of PCOS 2023. Monash University.
- NHS. Polycystic ovary syndrome.
- Endocrine Society. Polycystic Ovary Syndrome.
This article is for general information and does not replace advice from a doctor.