You've been diagnosed with PCOS. Or you're pretty sure you have it. Either way, you've probably sat in a GP appointment, been told your bloods "look fine", and left feeling more confused than when you walked in.

Here's the thing: standard NHS blood panels were not designed with PCOS in mind. They're built to rule out emergencies — not to map the hormonal dysfunction that's quietly driving your symptoms.

The research on this is actually pretty clear. PCOS is a metabolic and hormonal condition. The tests that reveal what's really going on are often not the ones routinely offered. And if you don't ask, you probably won't get them.

This is what I wish someone had told me.

A routine blood test at your GP might include TSH (thyroid), a full blood count, and basic hormone levels. That's it. For most people, that's enough. For someone with PCOS, it's barely scratching the surface.

PCOS is driven by a cluster of interacting factors: insulin resistance, elevated androgens, disrupted ovarian signalling, and often thyroid dysfunction. None of these will show up as "abnormal" on a standard panel — because they're not being tested for in the first place.

You're not imagining it. The system isn't built for this. But knowing what to ask for changes everything.

Here's your complete PCOS blood test checklist, broken down by category. Screenshot it. Print it. Take it to your appointment.

Insulin resistance affects up to 70% of women with PCOS — including those who are not overweight. It's one of the most important drivers of symptoms, and it's almost never tested by default.

• Fasting insulin — the gold standard for identifying insulin resistance. Not the same as fasting glucose. Ask specifically for this one.
• HbA1c — shows average blood sugar over the past 3 months. Useful for identifying metabolic risk, but won't catch early insulin resistance on its own.
• Fasting glucose — basic, but incomplete without fasting insulin.

Key note: A normal fasting glucose does not rule out insulin resistance. You can have normal glucose and significantly elevated insulin. This is exactly why fasting glucose alone misses the picture.

Elevated androgens — testosterone and DHEAS — are present in around 60–80% of PCOS diagnoses. They're responsible for acne, facial hair, hair thinning, and disrupted ovulation.

• Free testosterone — the biologically active form. Total testosterone can look normal while free testosterone is elevated.
• SHBG (sex hormone-binding globulin) — binds testosterone. When SHBG is low (common in insulin resistance), more free testosterone circulates. This is the actual problem.
• DHEAS (dehydroepiandrosterone sulphate) — an adrenal androgen. Elevated DHEAS can point to adrenal involvement rather than (or alongside) ovarian dysfunction — an important distinction for treatment.

Thyroid dysfunction and PCOS frequently co-exist, and symptoms overlap significantly: fatigue, weight gain, hair loss, irregular cycles, mood disruption. If your thyroid is underactive, treating PCOS alone won't resolve symptoms.

• TSH (thyroid-stimulating hormone) — the standard first marker. Aim for TSH below 2.5 mIU/L if trying to conceive.
• Free T3 and Free T4 — if TSH is borderline or symptoms persist, these give a fuller picture of thyroid function.
• Thyroid antibodies (TPO) — useful if autoimmune thyroid disease (Hashimoto's) is suspected.

Timing is critical here. Most reproductive hormone tests should be done on days 2–5 of your cycle. If your cycle is irregular, ask your GP how to proceed — testing mid-cycle or randomly gives misleading results.

• LH and FSH — in PCOS, the LH:FSH ratio is often elevated (above 2:1). This disrupts ovulation signalling.
• Oestradiol (E2) — baseline oestrogen; helps assess ovarian reserve alongside AMH.
• Progesterone (day 21 or 7 days before expected period) — confirms whether ovulation actually occurred. Low progesterone is a key sign of anovulatory cycles.
• Prolactin — elevated prolactin can mimic PCOS symptoms and suppress ovulation. Needs to be ruled out as a separate cause.

AMH is produced by follicles in the ovaries and is a marker of ovarian reserve — essentially, how many eggs you have left. In PCOS, AMH is often significantly elevated because there are many small, undeveloped follicles present.

AMH is useful for confirming PCOS, assessing fertility potential, and monitoring response to treatment. It can be tested at any point in your cycle. It's not routinely offered on the NHS but is widely available via private testing.

Test Why It Matters NHS or Private?

This is where a lot of women fall through the cracks. Your results come back. The GP says they're normal. But you still feel terrible.

Here's why: NHS normal ranges are designed to catch disease — not to optimise function. A fasting insulin of 18 mIU/L might technically fall within range but is associated with significant insulin resistance in clinical literature. A TSH of 4.0 might be flagged as acceptable when research consistently shows better outcomes with TSH below 2.5, particularly for fertility.

Root cause, not symptom suppression. That means understanding your actual numbers — not just whether they passed a threshold.

Let's be practical, because navigating NHS requests with PCOS can be frustrating.

• Come prepared. Write down your symptoms, their frequency, and how they're affecting daily life.
• Say the words: "I'd like to investigate PCOS more thoroughly. Can we test fasting insulin, androgens, and AMH?"
• If refused, ask why. Document it. You have the right to advocate for further investigation.
• Ask for a referral to an endocrinologist or reproductive specialist if your GP is unable to support you further.

If NHS access is limited, private blood testing has become increasingly straightforward and affordable in the UK. Many clinics and at-home testing services offer PCOS-specific panels that include the markers listed above.

Your body is trying to tell you something. A comprehensive blood panel is simply learning to listen properly.

Getting the tests is step one. Understanding what they mean — and what to do next — is where the real work begins.

• Bring your printed results to appointments. GPs see results through a disease-risk lens. You're asking about hormonal optimisation.
• If fasting insulin is elevated: blood sugar regulation is the priority. Nutrition, movement, and targeted supplementation can make a significant difference.
• If androgens are elevated: consider whether insulin resistance is driving it (common) or adrenal factors (check DHEAS).
• If thyroid markers are borderline: push for the full panel (T3, T4, antibodies) before accepting a "normal" verdict.

Hormonal literacy isn't complicated — it's just rarely taught. The more you understand your own numbers, the less you have to rely on appointments that last seven minutes.

Once you have your results and understand the picture, targeted supplementation becomes a much more intelligent tool — not a stab in the dark.

MyOva's Myoplus supplement is built around the nutrients with the strongest evidence base for hormonal and metabolic support: myo-inositol, and a targeted micronutrient profile designed to support insulin sensitivity, ovulation, and androgen balance.

It's not a magic fix. But it gives your body what it's often missing — particularly if insulin resistance is part of your picture.

Yes. You can request blood tests based on symptoms. A PCOS diagnosis is typically made using the Rotterdam criteria — which includes symptoms, ultrasound, and bloods — so raising concerns is entirely valid even pre-diagnosis.

Fasting glucose measures blood sugar at a single point in time. Fasting insulin measures how hard your pancreas is working to manage that blood sugar. You can have normal glucose with significantly elevated insulin — a state known as compensated insulin resistance, which is common in PCOS.

For most reproductive hormones (LH, FSH, oestradiol), day 2–5 of your cycle is optimal. Progesterone is best measured 7 days before your expected period. AMH, fasting insulin, and thyroid markers can be tested at any point in your cycle.

Request the actual numbers, not just the verdict. Compare them against functional optimal ranges (not just disease thresholds). If you're still struggling, a referral to an endocrinologist, reproductive specialist, or a functional medicine practitioner who works with hormonal health may give you more nuanced support.

MyOva is formulated around myo-inositol and D-chiro inositol, which have the strongest evidence base for improving insulin sensitivity, supporting ovulation, and reducing androgen levels in PCOS. It's designed to address root-cause drivers — not just manage symptoms.

This article is for informational purposes only and does not constitute medical advice. Always consult a healthcare professional.