Hypothalamic Amenorrhea vs PCOS
We talk a lot about hypothalamic amenorrhea in my practice as it is more common for those who have been dieting or have a history of an eating disorder. However, period problems can also be a sign of Polycystic Ovarian Syndrome (PCOS).
PCOS is a condition of excessive androgens (male sex hormones) and is associated with missing or irregular periods and/or polycystic ovaries. While PCOS is similar to HA in the sign of a missing cycle, they are both very clinically different hormone conditions that can be ruled out through thorough proper testing.
Hypothalamic amenorrhea is the result of under eating, over exercising and chronic stress. HA is often overlooked in the clinical setting as most practitioners mistake it for PCOS. If you have begun to cut calories, made a change in your diet recently, started an intense workout regimen or are experiencing chronic stress, it most likely is HA. Learn more about HA in this post.
Similarities and Differences
This chart is a brief summary of the distinctions between PCOS and hypothalamic amenorrhea.
Keep in mind that you may not exhibit all of the symptoms of your condition and treatment is highly individualized. Polycystic ovaries can occur in both PCOS and HA which is why PCOS should not be diagnosed by an ultrasound. It could be potentially harmful for someone going through HA to be told they have PCOS and be given the wrong treatment protocol.
Clinicians often tell patients with PCOS to “cut carbs, lose weight, and exercise more”…. which you can see why this adds fuel to the fire when you truly have amenorrhea. If you have confirmed PCOS and you struggle with bingeing, anxiety around food, constant food thoughts - you CAN manage your PCOS naturally without restricting carbs, gluten, sugar, etc.
Important questions to ask yourself:
Do you have a family history of PCOS?
What symptoms do you have? Hair loss or hair growth? Acne? Weight gain/weight loss? Low libido? Pain in lower abdomen?
Have you recently come off hormonal birth control?
Are you eating less than normally or adopted a new training program?
When did your period go missing?
Have you checked other possible causes of a missing period such as an eating disorder or thyroid condition?
In rare cases, it is possible to have HA and PCOS. This often requires eating more to correct the HA and then focus on treating PCOS through other diet and lifestyle modifications.
Also keep in mind that going to the doctor’s office to run a hormone panel at any given day is most likely not going to give you the most accurate reading of your hormones, as hormones are constantly ebbing and flowing every single day. The DUTCH test is one of the most accurate hormone tests available and requires working with a practitioner who can interpret the results to you.
Have additional questions? Leave a comment below or send your questions via email.
