Hormone Levels and PCOS Charts: What Hormone Imbalance Charts Look Like With PCOS

You may already know that PCOS causes hormone imbalance… but how much do you really know about the hormones affected? 

In this article, we’ll cover everything you need to know about hormone levels and PCOS charts, including which hormones your doctor may want to check, common PCOS symptoms to be aware of, and potential treatment options depending on your symptoms. 

What Is PCOS and How Does It Affect Hormones?

Polycystic Ovary Syndrome (PCOS) is a hormonal condition that affects approximately 8-13% of women of reproductive age. 

Individuals with PCOS have a chronic hormone imbalance, which can lead to the following three key symptoms: 

• Hyperandrogenism (high testosterone levels)
• Ovulatory dysfunction (inability to ovulate)
• Polycystic ovaries (ovaries containing multiple fluid-filled sacs or ‘follicles’) 

Because PCOS interferes with ovulation, conception can be difficult – but it’s certainly not impossible. Common treatments for infertility caused by PCOS include lifestyle changes and in some cases medication. 

Common Hormones Measured in PCOS Hormone Charts

PCOS can interfere with a range of hormones in the body. Here is a list (in alphabetical order) of the most common hormones that may be affected. 

• Androstenedione – a steroid hormone used to make estrogen and testosterone. Elevated androstenedione levels are associated with PCOS. 
• Anti-Müllerian hormone (AMH) – a protein hormone produced in reproductive tissues. Elevated AMH levels are associated with PCOS. 
• Cortisol – a steroid hormone that helps to regulate the metabolism and immune system. Elevated Cortisol levels are associated with PCOS.  
• Dehydroepiandrosterone Sulfate (DHEA-S) – a steroid hormone used to make estrogen and testosterone. Elevated DHEA-S levels are associated with PCOS. 
• Estrogen – a steroid hormone that helps regulate the menstrual cycle. Elevated estrogen levels in relation to progesterone are associated with PCOS.
• Follicle-stimulating Hormone (FSH) – a gonadotropic hormone that helps stimulate the development of premature ovarian follicles. Elevated FSH levels are associated with PCOS. Doctors also look at the relationship between FSH and LH (luteinizing hormone) when assessing PCOS – this is known as the LH to FSH ratio.
• Insulin – a peptide hormone that helps regulate blood sugar levels. Insulin resistance is associated with PCOS. 
• Luteinizing Hormone (LH) – a gonadotropic hormone responsible for regulating the menstrual cycle and triggering ovulation. Elevated baseline LH levels are associated with PCOS. 
• Progesterone – a steroid hormone that helps regulate the menstrual cycle and prepares the body for pregnancy. Lower than average progesterone levels are associated with PCOS. 
• Prolactin – a polypeptide hormone that supports lactation and breast tissue development. Elevated prolactin levels are associated with PCOS. 
• Testosterone – a steroid hormone that supports ovarian functioning and bone strength. Elevated testosterone (including free testosterone) levels are associated with PCOS.

Other biological markers that may be affected by PCOS include thyroid-stimulating hormone, sex hormone-binding globulin (SHBG), glucose, and vitamin D. 

Key Hormone Measurements for Diagnosing PCOS

The process of diagnosing PCOS often involves blood testing. This enables doctors to see if hormone levels are out of balance. In a typical PCOS blood test, the following four key hormone levels are examined closely. 

LH and FSH (i.e. the LH to FSH Ratio)

When measured at the beginning of the menstrual cycle, LH and FSH levels should be about the same. This 1:1 ratio between LH and FSH indicates a healthy cycle. However, in cases of PCOS, baseline LH levels tend to be elevated. This can cause the LH to FSH ratio to be 2:1 or even 3:1. 

In addition to elevated baseline LH levels, it’s also common for PCOS patients to see their LH levels fluctuate across the menstrual cycle, with no prominent peak. This is why standard ovulation predictor kits (OPKs) do not work on PCOS cycles. 

Insulin 

A key symptom of PCOS is insulin resistance, which affects approximately 65-70% of PCOS patients. 

To assess insulin resistance, doctors often look at fasting insulin levels. A fasting insulin level between 5-15 μU/mL is considered healthy. When fasting insulin levels are elevated beyond this standard threshold, this is a sign of insulin resistance. 

Alongside fasting insulin levels, doctors may also want to check fasting glucose levels and hemoglobin A1C levels to assess insulin resistance in PCOS patients. 

Testosterone 

When insulin levels are elevated, the ovaries ramp up the production of testosterone. This is why it’s normal to see elevated testosterone levels in PCOS patients. 

Among women between the ages of 19-49, testosterone levels typically range from 8-48 ng/dL. PCOS patients may see testosterone levels above 48 ng/dL but not higher than 150 ng/dL. Testosterone levels beyond 200 ng/dL could indicate an ovarian or adrenal tumor. 

Additional Diagnostic Criteria

In addition to testing hormone levels when diagnosing PCOS, doctors will also want to assess any physical signs and symptoms. 

For example, to see if the ovaries are polycystic, a pelvic ultrasound may be necessary. 

Other common symptoms of PCOS include: 

• Irregular menstrual cycles – which are associated with anovulation, missed periods, irregular periods, heavy menstrual bleeding, and difficulty getting pregnant
• Excessive hair growth (hirsutism) – particularly on the face, arms, back, chest, thumbs, toes, abdomen, and upper thighs
• Hair loss (androgenetic alopecia) – male-patterned baldness and hair loss on the top of the head 
• Changes to skin – leading to increased acne, skin tags, and dark patches 
• Unexpected weight gain – leading to high cholesterol, high blood pressure, and insulin resistance

PCOS also increases the risk for certain mental health challenges, such as burnout, fatigue, mood swings, anxiety, and depression. 

PCOS Phenotypes Explained 

You may have heard or read about ‘PCOS phenotypes’. PCOS phenotypes are simply the different classifications of PCOS, with each phenotype encompassing a distinct combination of symptoms. Here is a brief overview of each phenotype and its associated symptoms. 

• Phenotype-A – symptoms include hyperandrogenism, ovulatory dysfunction, and polycystic ovaries 
• Phenotype-B – symptoms include hyperandrogenism and ovulatory dysfunction
• Phenotype-C – symptoms include hyperandrogenism and polycystic ovaries
• Phenotype-D – symptoms include ovulatory dysfunction and polycystic ovaries 

By grouping patients into different phenotypes, doctors can provide more tailored advice and treatment depending on the combination of symptoms. 

Treating PCOS: Lifestyle, Medications, and Supplements

Taking into account an individual’s symptoms, ultrasound, and blood test results, doctors can provide guidance on treatment. 

Lifestyle adjustments are often the first line of treatment to promote hormone balance. Typical recommendations include: 

• Eating a well-balanced, nutrient-rich diet to avoid blood sugar spikes 
• Getting plenty of exercise to combat insulin resistance 
• Keeping stress levels low to help regulate cortisol levels
• Making sleep a priority to promote positive well-being and combat insulin resistance 

In addition to lifestyle changes, certain medications can also promote hormone balance. One option is hormonal birth control (specifically one that contains estrogen and progestin). This type of combined oral contraceptive can help to decrease testosterone levels, regulate the menstrual cycle, and reduce the impact of heavy, painful menstrual periods. 

For those actively trying to conceive (TTC), hormonal contraception will not be an option. However, medications such as letrozole and clomiphene can help to induce ovulation and promote cycle regularity. 

Beyond medication, healthcare providers may also recommend taking supplements. For example, research shows natural remedies such as curcumin, vitamin D, inositol, and coenzyme Q10 can all help to combat insulin resistance and inflammation while also helping to balance hormones. Mira’s own PCOS Supplements contain the ideal 40:1 ratio of Myo and D-Chiro inositol – helping to restore ovulation and cycle regularity. 

Hormone Tracking With PCOS

Staying on top of your hormone levels with PCOS can be a challenge. Doctors’ appointments often feel few and far between, and sometimes it’s hard to tell if any lifestyle adjustments are actually making a difference. 

However, thanks to the Mira App and Hormone Monitor, tracking your hormones with PCOS is easy. With Mira, you can track up to four key fertility hormones (LH, PdG, E3G, and FSH) in urine with lab-grade accuracy – all from the comfort of your home. When tracked consistently over time, you can see your unique hormone curves, estimate your fertile window, and pinpoint ovulation. 

To learn more about how Mira supports individuals with PCOS, visit How Mira Works: PCOS. 

Additional Support 

Whether you’re just looking to balance your PCOS hormones or you’re actively trying to plan a pregnancy, our team of fertility experts in our Hormone Health Clinic for Fertility is here to support you! 

They can help you: 

• Gain a better understanding of your PCOS diagnosis, lab results, and what the diagnosis means for your health
• Develop a personalized action plan to balance your hormones 
• Feel emotionally supported throughout your PCOS journey 

Our coaches are also well-versed in all of our Mira products, so they can answer any questions you may have, help you get started with hormone testing, and interpret your hormone level charts in the Mira App.  

Final Thoughts

We still have a lot to learn about PCOS, but we are excited about what the future holds. To learn more about our mission and how we’re helping individuals better understand their bodies and hormones, check out our Sex Hormones Awareness Week campaign. 

If you are actively TTC, you may find our article How to Get Pregnant with PCOS: 11 Tips to Get Pregnant Fast helpful for planning a pregnancy alongside a PCOS diagnosis. 

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