05/28/2021
PCOS is a commonly misdiagnosed condition.
The diagnostic criteria allow for many differing presentations. However, PCOS is a diagnosis of exclusion; meaning that even if a patient’s symptoms look like PCOS, other possible diagnosis must be ruled out. This, unfortunately, is not always the case and women are being over-diagnosed with PCOS.
So what other conditions can look like PCOS?
1. Hypothalamic amenorrhea. Especially when “lean PCOS” is suspected. It can be due to energy imbalance, signifiant stress, exercise, or weight loss. Like PCOS this condition presents with the lack of a period. Testing pituitary hormones like LH, FSH, and estrogen can help make this diagnosis
2. Hyperprolactinemia or a prolactinoma. When your body is over secreting prolactin (the lactation hormone) you can experience irregular cycles, acne, and excessive hair growth. A simple blood test can tell us where your prolactin is at
3. Non-classic Congenital Adrenal Hyperplasia. This condition presents exactly like “classic PCOS” with polycystic ovaries, high androgens, and irregular cycles. A blood test called 17-OH Progesterone will help rule in this condition.
4. Hypothyroidism. Low thyroid function can cause irregular cycles and weight gain, which can look like PCOS.
5. Cushing Syndrome. A condition where your body over secretes cortisol. Symptoms can include weight gain, increased hair growth, irregular cycles, and acne.
6. Young age. It is normal to have multi-cystic ovaries in adolescence! Therefore, ultrasound should NOT be used as a criteria for making a PCOS diagnosis in this population. If it is, PCOS can easily be over-diagnosed.
If you are questioning your PCOS diagnosis then lets connect or get you connected with someone who can thoroughly investigate your unique case!
