How do doctors differentiate between hyperthyroidism and PCOS?
Hyperthyroidism and PCOS are not uncommon causes of irregular periods and both can also cause scalp hair loss. To differentiate between the 2, history and physical examination are useful, and blood test will be able to confirm if there is hyperthyroidism or not.
Symptoms of hyperthyroidism include weight loss, increased in heart rate, increased sweating, tremors, difficulty sleeping, increased irritability and increased bowel movement (basically everything speeds up). In PCOS, women tend to (but not always) notice that their symptoms correspond to a period of weight gain and may have symptoms of excess male hormones such as acne, increased facial hair or scalp hair loss.
Some signs of hyperthyroidism can be picked up on physical examination (tremors, increased heart rate, enlarged thyroid gland etc) and this is confirmed by doing a thyroid function test (blood test). If the thyroid function test is completely normal, then the symptoms experienced are not due to hyperthyroidism.
PCOS is a clinical diagnosis where 2 out of the following 3 criteria are met.
1. Irregular periods (longer cycles)
2. Symptoms of signs of excess male hormones (acne, increased facial hair or scalp hair loss)
3. Polycystic ovaries on ultrasound scan
If you have hyperthyroidism on blood test, as well as features of PCOS, I would suggest normalizing the thyroid function first to see if the periods become regular and symptoms (eg hair loss) improve.
I hope this helps.
Dr Marilyn Lee
MBBS, MRCP, FAMS
38 Irrawaddy Road #06-52
Mount Elizabeth Novena Specialist Centre
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