What conditions mimic Polycystic Ovary Syndrome (PCOS)?

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Dainyal Siddiqui, MD

Internal Medicine

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Manuel Jimenez, MD

Cardiology

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Franz Pierre-Louis, MD

Infectious Disease

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Last updated: May 6, 2025 • View editorial policy

Differential Diagnosis for Conditions that Mimic PCOS

  • Single most likely diagnosis: + Congenital Adrenal Hyperplasia (CAH): This condition can present with similar symptoms to PCOS, such as hyperandrogenism, irregular menstrual cycles, and infertility. CAH is a group of inherited disorders that affect the adrenal glands, leading to an overproduction of androgens.
  • Other Likely diagnoses: + Thyroid dysfunction: Both hypothyroidism and hyperthyroidism can cause menstrual irregularities and hyperandrogenism, mimicking PCOS. + Hyperprolactinemia: Elevated prolactin levels can disrupt menstrual cycles and cause hyperandrogenism, similar to PCOS. + Cushing's syndrome: This rare endocrine disorder can cause hyperandrogenism, weight gain, and menstrual irregularities, similar to PCOS. + Androgen-secreting tumors: Ovarian or adrenal tumors that secrete androgens can cause symptoms similar to PCOS.
  • Do Not Miss diagnoses: + Pituitary adenoma: A tumor in the pituitary gland can cause hyperprolactinemia, leading to symptoms similar to PCOS. If left untreated, pituitary adenomas can lead to serious complications. + Adrenal carcinoma: A rare but aggressive tumor that can cause hyperandrogenism and other symptoms similar to PCOS. Early diagnosis and treatment are crucial to prevent serious consequences.
  • Rare diagnoses: + Gonadal dysgenesis: A rare condition where the gonads (ovaries or testes) do not develop properly, leading to hyperandrogenism and menstrual irregularities. + Steroidogenic enzyme deficiencies: Rare genetic disorders that affect the production of steroid hormones, leading to hyperandrogenism and other symptoms similar to PCOS. + Idiopathic hyperandrogenism: A rare condition characterized by excessive androgen production without a clear underlying cause, which can mimic PCOS.

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