Hello,
Many PCOS patients see their doctor once or twice a year. The labs ordered at those visits vary widely depending on the practice, the country, and the practitioner's familiarity with PCOS.
Here's the panel that comes up most often in PCOS-aware practice guidelines, with what each one is actually for. (Not medical advice; the lab vocabulary glossary in the PCOS Wellness OS, page 83, has the longer version.)
Metabolic
- Fasting glucose: baseline blood sugar
- HbA1c: 8-12 week glucose average
- Fasting insulin (and HOMA-IR if calculated): your insulin response
- Lipid panel: cholesterol + triglycerides; PCOS shifts these
Hormonal
- Total testosterone: total in blood, both bound and free
- Free testosterone: the active fraction; matters more in PCOS
- SHBG: protein that binds testosterone; lower SHBG = more free testosterone
- LH and FSH: pituitary hormones; ratio sometimes elevated in PCOS
- AMH (anti-Müllerian hormone): follicle count proxy; higher in PCOS
- DHEAS: adrenal androgen; helps distinguish ovarian vs adrenal contribution
Adjacent Markers Worth Including
- Vitamin D (25-OH): often low in PCOS; affects symptom severity
- TSH, Free T3, Free T4: thyroid; PCOS overlaps with thyroid issues
- CRP (high-sensitivity): inflammation marker
- Fasting iron / ferritin: PCOS-adjacent anemia is underdiagnosed
How to Ask for This List
If your doctor doesn't routinely order all of these, you can ask: "Would it be useful to add [specific lab] to this draw — I've been seeing [specific symptom] and I'm curious whether [specific marker] might explain part of the pattern."
Specific question gets a specific answer. Vague request gets vague labs.
The Doctor Visit Prep template (page 49) has a checklist of these labs you can bring. The Lab Results Tracker (page 51) gives you a place to log them across visits so the trends — not just the single value — become visible.
Annual labs are the foundation. Trends are the story.