- PCOS is a varied condition requiring specific tests beyond standard panels for diagnosis
- Four PCOS types include insulin-resistant, post-pill, inflammatory, and adrenal-driven forms
- Insulin-resistant PCOS affects 70% of women and needs insulin and glucose-related tests
PCOS is one of the most common hormonal conditions today, yet it is also one of the most confusing. Many women get diagnosed after dealing with symptoms like irregular periods, acne, weight changes, or hair fall, but still do not get clear answers on why it is happening. That is where things often go wrong. PCOS is not a one-size-fits-all condition, and treating it like one can lead to frustration and slow progress.
Nutritionist Rashi Chowdhary shares an important take on Instagram: not all PCOS is the same, and running the wrong tests is a big reason why many women feel stuck. As she explains, most doctors stick to a “standard panel” like TSH, testosterone and ultrasound, and call it comprehensive. But that does not always tell you what's actually driving your symptoms.
The health expert breaks PCOS down into four types – and here's what you should test for in each case:
1. Insulin-Resistant PCOS (Most Common)
This affects nearly 70% of women with PCOS. Here, high insulin levels push the ovaries to produce more androgens. The tricky part? Your blood sugar may still look normal.
Tests to ask for:
- Fasting & post-meal insulin
- Fasting glucose, HOMA-IR, HbA1c
- Total & free testosterone + SHBG
- Salivary cortisol
2. Post-Pill PCOS
This happens after stopping birth control pills. Hormones temporarily go out of balance, making it look like PCOS.
As she points out, this can settle in 3–6 months if there was no PCOS earlier.
Tests to ask for:
- LH, FSH, LH:FSH ratio
- Estradiol, AMH
- Total testosterone + SHBG
- hs-CRP
3. Inflammatory PCOS
Here, chronic low-grade inflammation is the trigger. It often shows up with gut issues, skin problems, fatigue, or joint pain.
Tests to ask for:
- hs-CRP, homocysteine
- Vitamin D, magnesium (RBC)
- Total testosterone + SHBG
- Androstenedione
4. Adrenal PCOS (Most Missed)
This type is driven by stress, not insulin. Androgens come from the adrenal glands, not ovaries. It is often seen in lean women with regular cycles but symptoms like acne or hair fall.
Tests to ask for:
- DHEA-S, cortisol
- Prolactin
- Testosterone panel + SHBG
- Progesterone, estradiol, LH, FSH
Rashi Chowdhary also highlights something most people ignore: timing matters.
- Day 2–5: Hormone tests like LH, FSH, estradiol
- Day 21: Progesterone
- Fasting: Insulin, glucose, inflammation markers
The nutritionist's core message is simple: do not just test randomly; test with a purpose. Knowing your type of PCOS helps you take the right next steps instead of guessing.
Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.
