Do Women with PCOS Need Blood Tests for Monitoring?

Is blood testing necessary for monitoring polycystic ovary syndrome (PCOS)?

Hello Doctor, I have had irregular menstruation since I started my period in the second year of junior high school.
After not having my period for six months, I went to a gynecology clinic and was prescribed medication to induce menstruation.
Sometimes my period would come on its own, but most of the time it wouldn’t, so I only went to see the doctor every six months.
This continued until 2014 when the doctor suggested I might have polycystic ovary syndrome (PCOS) and referred me to a larger hospital for blood tests.
At the end of 2014, the blood tests confirmed that I had PCOS, with elevated male hormones and low estrogen levels.
I took blood sugar-lowering medication for a while, but later, due to the heavy burden of follow-ups at the large hospital, I returned to my original clinic.
I continued taking the medication to induce menstruation because I didn’t want to take birth control pills to regulate my cycle.
The doctor prescribed another medication, and when I took it, my periods became regular.
However, there was a period when I didn’t see the doctor and stopped taking medication, and my periods completely stopped.
During this time, I visited another gynecology clinic where the doctor said my endometrium was too thin and prescribed medication for me.
After several follow-ups, my endometrium remained thin, so I returned to my original clinic to get medication to induce menstruation (by this time, I hadn’t had my period for six months).
After my period came, the doctor prescribed ESTROMON F.C.
TABLE and SHITON 5MG (I’m not sure if I wrote that correctly; there are more ingredients).
I started taking these two medications on the fourth day of my period, with different weekly dosages.
After completing three weeks, I waited for my period to come.
I have now completed three cycles and had my period three times, but I am currently worried about the thin endometrium.
I would like to ask if blood tests are necessary to monitor PCOS.
I have only had one blood test for diagnosis; if follow-up blood tests are needed, on which day of the menstrual cycle is it best to draw blood? Additionally, does having a thin endometrium have significant implications? I am considering whether to continue taking this medication, as this doctor has not mentioned the issue of the thin endometrium at all.
The previous doctor only addressed the thin endometrium, so I am unsure whether to prioritize resolving the thin endometrium issue or to continue taking the medication to induce menstruation.
I apologize for the lengthy message, and thank you, Doctor!

Niming, 20~29 year old female. Ask Date: 2017/02/20

Dr. Huang Jianzhong reply Obstetrics and Gynecology

1.
Since my first menstruation, my menstrual cycle has not been very regular.
In the second year of junior high school, I did not have my period for six months.
I went to a gynecology clinic and was prescribed medication to induce menstruation.
Sometimes my period would come on its own, but most of the time it did not.
I would visit the clinic every six months to get the medication.
This continued until 2014, when the doctor suggested that I might have polycystic ovary syndrome (PCOS) and referred me to a larger hospital for blood tests.
At the end of 2014, the blood tests confirmed that I had PCOS, with elevated androgen levels and low estrogen levels.
I took blood sugar-lowering medication for a while, but later, due to the burden of follow-up visits at the large hospital, I returned to my original clinic for the medication to induce menstruation.
I did not want to take birth control pills to regulate my cycle, so the doctor prescribed another type of medication.
When I took it, my periods became regular.
However, there was a period when I did not go for check-ups and did not take any medication, and my periods completely stopped.
During this time, I visited other gynecology clinics for examinations, and the doctors said my endometrium was too thin and prescribed medication for me.
After several follow-ups, my endometrium remained thin.
Since I was continuously prescribed medication to thicken the endometrium, I returned to my original clinic to get the medication to induce menstruation (by this time, I had not had my period for six months).
After my period came, the doctor prescribed ESTROMON F.C.
TABLE and SHITON 5MG (not sure if this is the correct name, there are more ingredients).
I started taking these two medications on the fourth day of my period, with different dosages each week.
After completing three weeks, I would wait for my period to come.
I have now completed three cycles, and my period has come three times, but I am currently worried about the issue of a thin endometrium.
Answer: A thin endometrium may lead to infertility, but I will only know after getting married.
2.
Do I need to have blood tests to monitor polycystic ovary syndrome? Answer: Yes, blood tests are necessary for monitoring.
3.
I have only had one blood test so far.
If I need to have blood tests for monitoring, on which day of my menstrual cycle is it best to have the blood drawn? Answer: It is best to avoid the days around ovulation.
4.
Does having a thin endometrium have significant effects? Answer: A thin endometrium may lead to infertility, but I will only know after getting married.
5.
I am considering whether to continue taking this medication because this doctor has not mentioned the issue of a thin endometrium at all.
The previous doctor only addressed the thin endometrium issue.
Therefore, I am unsure whether to prioritize resolving the thin endometrium problem or to continue taking the medication to induce menstruation.
Answer: Continue taking the medication to induce menstruation.

Reply Date: 2017/02/20

More Info

Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder that affects women of reproductive age. It can lead to a variety of symptoms, including irregular menstrual cycles, excessive hair growth, acne, and obesity. One of the key aspects of managing PCOS is monitoring hormone levels and other related health indicators through blood tests.

Do Women with PCOS Need Blood Tests for Monitoring?
Yes, women with PCOS should have regular blood tests to monitor their hormone levels and overall health. These tests can help assess the levels of androgens (male hormones), insulin, and other hormones that may be out of balance due to PCOS. Regular monitoring is crucial because it allows healthcare providers to tailor treatment plans based on the individual's hormonal profile and symptoms.

When Should Blood Tests Be Conducted?
For women with PCOS, blood tests are typically recommended at specific times during the menstrual cycle to ensure accurate results. The best time to conduct tests for hormones such as Luteinizing Hormone (LH), Follicle-Stimulating Hormone (FSH), and testosterone is usually on the third day of the menstrual cycle (Day 3). This timing helps to evaluate the baseline hormone levels before ovulation occurs. If a woman is not having regular menstrual cycles, the healthcare provider may suggest a specific time based on her unique situation.

Importance of Monitoring Hormone Levels
Monitoring hormone levels is essential for several reasons:
1. Diagnosis Confirmation: Blood tests can help confirm the diagnosis of PCOS by measuring hormone levels and ruling out other conditions that may cause similar symptoms.

2. Treatment Adjustment: If a woman is on medication to manage her PCOS symptoms, such as hormonal contraceptives or insulin-sensitizing agents, regular blood tests can help determine if the treatment is effective or if adjustments are needed.

3. Assessing Risks: Women with PCOS are at a higher risk for developing other health issues, such as type 2 diabetes, cardiovascular disease, and endometrial cancer. Regular monitoring can help identify these risks early.

Concerns About Thin Endometrial Lining
You mentioned concerns about having a thin endometrial lining. A thin endometrial lining can affect fertility and may lead to irregular menstrual cycles. It is essential to address this issue, especially if you are considering pregnancy in the future. The treatment for a thin endometrial lining often involves hormonal therapy, which can help thicken the lining and promote regular menstrual cycles.

If your current healthcare provider has not addressed the thin endometrial lining, it would be prudent to discuss this concern with them. They may recommend additional tests or treatments to help improve the thickness of the lining while managing your PCOS symptoms.

Conclusion
In summary, women with PCOS should have regular blood tests to monitor their hormone levels and overall health. These tests are crucial for diagnosing the condition, adjusting treatments, and assessing risks for other health issues. Blood tests are ideally conducted on Day 3 of the menstrual cycle, but if cycles are irregular, your healthcare provider will guide you on the best timing. Additionally, addressing concerns about a thin endometrial lining is important, and you should feel empowered to discuss this with your healthcare provider to ensure comprehensive care.

Similar Q&A

Understanding Blood Tests for Irregular Menstrual Cycles and PCOS Diagnosis

I haven't had my period for three months, and it has been irregular before (not coming). I had an ultrasound during my check-up, but the doctor didn't say much. Recently, I sought medical help to induce menstruation, but the doctor said I need to have blood drawn on the...

Dr. Xu Junzheng reply Obstetrics and Gynecology
1. Generally, the hormones secreted by the ovaries and pituitary gland are related to menstruation. 2. Polycystic ovary syndrome can be diagnosed through the aforementioned tests, clinical presentation, and ultrasound. Thank you.

Understanding the Link Between PCOS and Diabetes: Is Testing Necessary?

A few days ago, I went to the hospital for an examination and was diagnosed with polycystic ovary syndrome (PCOS). The doctor mentioned that I need to have more blood tests because there is a possibility of developing diabetes after middle age, especially since I have a family hi...

Dr. Lin Zhaopei reply Obstetrics and Gynecology
Polycystic ovary syndrome (PCOS) is associated with increased body fat and obesity in women, which can hinder the conversion of androgens to estrogens. In addition to infertility and irregular menstruation, some women may exhibit male characteristics. There is also a higher risk ...

Understanding PCOS: Key Blood Test Insights and Fertility Considerations

1. Hello, doctor. A few days ago, I had blood tests for AMH, LH, E2, and FSH. The doctor mentioned that it is not necessary to have the blood drawn on the third day of my menstrual cycle. How do they determine the timing for these tests, and will the differences in timing signifi...

Dr. Wu Xianghui reply Obstetrics and Gynecology
1. Polycystic Ovary Syndrome (PCOS) must meet the following criteria: irregular menstruation, laboratory test results consistent with the condition, and transvaginal ultrasound findings of bilateral multiple follicles in the ovaries. (Obesity, hirsutism, and metabolic syndrome ar...

Do You Need to Test for PCOS on Day 3 of Your Period?

Dear Dr. Huang, 1. Should blood tests for polycystic ovary syndrome (PCOS) such as LH, FSH, insulin, and testosterone be conducted on "day 3 of the menstrual cycle," or can they be done at any time? 2. Among the testosterone levels measured on day 3 and day 25 of a 40-...

Dr. Huang Jianxun reply Obstetrics and Gynecology
I apologize, but please consult a fertility specialist regarding this issue.