PCos or hypothalamic amenorrhea? how to tell the difference

So which is it? PCOS (poly cystic ovarian syndrome) Or HA (hypothalamic amenorrhea). Sometimes it is hard to tell the difference between the two because symptoms of pcos can be similar to those of HA.

  • Cysts on ovaries (seen through ultrasound)
  • Absence of periods also known as amenorrhea

Many doctors will conduct an ultrasound to diagnose PCOS, however, HA women also have cystic ovaries so are misdiagnosed regularly.

that’s where the commonality list ends. There are a multitude of other characteristics that differentiate PCOS from hypothalamic amenorrhea and I’m going to tell you what those are! One of the most common misdiagnosis of HA is PCOS. SO, how do you know if you have a genetic condition or just shut down your reproductive system?

how to tell the different sign and symptoms of PCOS vs hypothalamic amenorrhea
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Disclaimer: This is not medical advice and should not be taken as such. I am not a doctor and do not claim to be as these are solely based on my experiences. Please consult your family doctor before considering any recommendations listed in this post. Thanks!

What is Hypothalamic amenorrhea

Hypothalamic amenorrhea (HA) is an absence of period for 3 or more consecutive months. HA is developed due to 3 key factors:

  • Under eating
  • Over exercising
  • And stress

There you have it ladies, the recipe for hormonal disaster! These 3 happenings will cause your hypothalamus (key producer of hormones in your brain) to shut down the communication between the ovaries. This process is called the HPO axis (hypothalamic – pituitary -ovarian axis) AKA the controller of your endocrine system. When you combine under eating, over exercise, and stress together your body considers the environment unsafe to reproduce. Additionally, your body is protecting you from the potential stress pregnancy would put on your body at that time.

Symptoms of HA include:

  • Feeling cold constantly
  • Missing period
  • Low sex drive
  • Low or absent levels of cervical mucus
  • Mood issue/anxiety/depression
  • Insomnia and sleep disorders
  • Gut issues

Check out Ova moons supplements to help aid in hormonal balance (pssssst it really helps with PMS symptoms!!)

What is PCOS

PCOS is short for polycystic ovarian syndrome and is a genetic condition, not a byproduct of your lifestyle and behaviors. It is a condition in which your ovaries produce an excess of androgens (male sex hormones). Normally, Women contain a small amount of androgens but in women with PCOS, those levels will be higher.

The exact cause of PCOS is unclear, however, it has a lot to do with one’s genetic makeup. Therefore, if your mother or grandmother has the condition, it is likely you may have it as well.

It is difficult to detect in adolescent years as a woman will normally find out she has PCOS during puberty as her sex hormones develop. Not wanting to deal with the side effects, doctors will usually put young women on the pill to “regulate” their hormonal levels. I could not disagree with this more…

The pill does not regulate hormones, It hyjacks them which is a whole other story you can read right HERE. I could go on and on about the pill and its misuse BUT lets stick to PCOS.

Symptoms of PCOS include:

  • Irregular cycles, missed period, and/or light periods
  • Excess body hair growth (chin, back, stomached)
  • Weight gain and inability to lose weight
  • Acne especially in the chin area
  • Hair loss or thinning hair

Detecting pcos in puberty

Teenagers going through puberty NATURALLY have high androgen levels and insulin resistance. This is because your body is trying to gain weight to enter its reproductive ages (you need fat to reproduce healthfully). You may notice (I defiantly did) that teenagers going through puberty may excel in sports and become stronger, this is due to the increased male sex hormone production! How cool!

A woman’s cycle can take up to 10 years to regulate so please, if you have a daughter – do not just go to the doctor to get prescribed oral contraceptive. Her body is just trying to figure itself out! Instead, I suggest promoting a healthy diet, regular exercise, and stress management! – moral of the story, it’s probably not PCOS if she’s going through puberty.

However, after a mature cycle has been established and one still shows symptoms of pcos then the likely diagnosis is indeed PCOS.

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The differences between symptoms of PCOS and HA

Now for the answer you have been waiting for, how do you know if you have HA or PCOS?

Let’s begin with symptoms of pcos and HA to determine which condition you are struggling with. Having HA, as mentioned above is the combination of an imbalance of energy availability due to lifestyle choices. It is common for HA sufferers to also have an eating disorder or patterns of disordered eating along with a low BMI or low body fat percentage.

This is very different than with women with PCOS. A major sign of PCOS is insulin resistance which can make it next to impossible to lose weight and/or these women will gain weight quickly.

Secondly, women with HA will have no period what so ever whereas women with PCOS typically have very long cycles or irregular periods. Looking for signs of ovulation can be very helpful in determining whether you suffer from HA or PCOS as PCOS women will occasionally have an ovulatory cycle.

The difference between pcos and ha: hormone levels

Women with HA will have low levels of everything – estrogen, progesterone, testosterone, and a low LH: FSH ratio. This is due to the inactivity of the hypothalamus.

Women with PCOS will have high testosterone, increased insulin, and a high LH: FSH ratio.

These can only be detected if you do bloodwork, which I highly recommend doing if you struggle with either of these conditions. Test do not guess!

How to support your body if you have HA

Having HA is considered a hormonal emergency, or at least it should be! Having low levels of hormones not only takes away your menstrual cycle, it also causes bone loss that can later turn into osteopenia or osteoporosis. Each year a women has HA, bone density is lost. Once bone density is lost it is very harder to get back than it is to keep.

Recovering your period should be at the top of your priority list. How can you get your period back?

  • Eat enough (minimum of 2500cals a day)
  • Tapper back exercise to low intensity or none at all
  • Manage stress levels

Want to know how I got my period back after 4 years of HA? Click here

How to support your body if you have PCOS

I am first and formost and advocate for natural approches. Diet, exercise, and stress managment has shown to be the best practice for hormonal balance and is what I recommend you do if you have been diagnosed with PCOS.

Alisa Vitti – author of “womancode” and “in the flo” has suffered with PCOS herself and created a method called cycle syncing (R) that promotes optimizing key hormones at each phase of your cycle. Women with PCOS and even women with out the condition can benefit greatly of practicing this method!

Not sure what cycle syncing (R) is? read this post!

Closing thoughts

It can be tricky to tell the difference between symptoms of pcos and HA, Im hoping this article gave you some insight!

Whether you suspect your diagnosis to be HA or PCOS always go to your doctor and get their professional opinion. However, that doesnt mean you cant know a thing or two about both conditions and make an educated decision about your body!

Let me know if this post was helpful for you in the comments below:) I love to connect with my readers (aka you) and dont forget to follow me on my instagram and pinterest!


  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6489978/
  2. https://academic.oup.com/jcem/article/84/6/1775/2864158

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