It's quite typical for doctors to first diagnose PCOS, or polycystic ovarian syndrome, in women with hypothalamic amenorrhea.
I had a few clients who had been misdiagnosed with PCOS because of the symptom of menstrual cycle irregularities. But what is precisely the difference between the two?

What distinguishes hypothalamic amenorrhea from polycystic ovarian syndrome (PCOS)?

A hormonal issue that occurs during the reproductive years is known as a polycystic ovarian syndrome (PCOS). Periods may not frequently happen if you have PCOS. Alternatively, you can get prolonged menstruation. Another possibility for you is that your body contains too much of the hormone androgen.
An imbalance in the pulsatile release of the gonadotropin-releasing hormone causes hypothalamic amenorrhea, also known as hypothalamic hypogonadism, in which a woman does not have menstruation (GnRH). This anomaly is blamed on poor food, ongoing stress, or too much exercise.
Because of how similar the two disorders are, your doctor may wrongly diagnose you with PCOS when you have hypothalamic amenorrhea.

How will you know if it is PCOS or Hypothalamic Amenorrhea?

These variations in the two groups point to two conclusions. First, since these women don't have any other symptoms of PCOS and have normal gonadotropin levels, hypothalamic amenorrhea should be considered a potential cause of their missed periods. Second, neither ailment is simple to diagnose because there are various symptoms ranging from severe to moderate.
We can tell you, however, that if you regularly engage in high-intensity exercise, restrict your diet (either in quantity or variety), have lost a significant amount of weight recently (typically 10+ pounds), or have experienced acute or ongoing stress (including the stress of being a perfectionist, which many of us are!) hypothalamic amenorrhea rather than PCOS may very well cause a missing period.

How do you begin your treatment when you are unsure whether you have one or both?

I am aware that the standard PCOS recovery procedure differs from HA, which can be confusing.
The recommendation to eat healthily, reduce calories, and frequently exercise commonly comes with PCOS.
HA, precisely the reverse.
People who genuinely have PCOS frequently also develop HA because they overdid their diet and exercise routines to manage it.
I don't necessarily adhere entirely to either of those approaches.
Recovery from both conditions can actually be approached similarly; treating HA with a diet and relaxation plan will benefit PCOS at the same time.

Anastasiia De La Cruz