PCOS Misdiagnosis: When It Isn't Actually PCOS

ByTarin Hussain
Updated: 5 Jan 2026, 8:00 am
Medically Reviewed by Dr. N Sapna Lulla,

Many people get told they have polycystic ovary syndrome (PCOS) after a quick ultrasound or because their periods are irregular. But PCOS is one of the most overdiagnosed and misdiagnosed conditions today. Sometimes the label sticks when the real problem is something else completely. Knowing why this happens can save you years of worry, wrong treatment, and unnecessary stress.

Pregatips
Polycystic ovary syndrome (PCOS) is often seen as the default explanation for irregular periods, stubborn acne, or unexplained weight changes. Countless women leave their doctor’s office convinced they have PCOS, even when the cause might be something else. While it can be life-changing for those who truly have it, misdiagnosis is surprisingly common, and it can leave women feeling confused, frustrated, or even hopeless. Imagine being told your symptoms are tied to PCOS, only to discover later that the real issue lies elsewhere.
In this article:

PCOS misdiagnosis can delay effective care and even affect fertility plans. Understanding why it is sometimes misdiagnosed can help you take control of your health with more clarity and confidence.

What Is PCOS and How Is It Diagnosed?

PCOS is a hormonal condition where at least two of the following three markers must be present:
  • Irregular or absent periods. This means your cycles may be unpredictable, sometimes skipping months or being very far apart.
  • Raised androgen levels: These are male hormones that can be higher than usual in women and may cause extra facial or body hair, acne, or elevated blood levels.
  • Ovaries that look polycystic on ultrasound: This means the ovaries appear larger than normal and have many small follicles (little fluid-filled sacs).
Having just one of these is not enough to diagnose PCOS. For example, even if an ultrasound shows “polycystic ovaries,” it doesn’t automatically mean you have PCOS.

Why Do So Many Women Get Told They Have PCOS When They Don’t?

The biggest reason is single-symptom diagnosis. Doctors sometimes label PCOS based only on irregular cycles or only on an ultrasound report that says “polycystic ovaries”.

In reality, many teenage girls and young women naturally have irregular periods for the first few years after puberty, and polycystic-looking ovaries are very common without any illness.

Stress, sudden weight loss, over-exercising, thyroid problems, or even being on certain birth control pills can cause exactly the same symptoms without any connection to PCOS.

Which Conditions Are Most Often Mistaken for PCOS?

Several health issues can look remarkably similar to PCOS:
  • Thyroid disorders (especially low thyroid): An underactive thyroid can slow your metabolism, cause weight gain, fatigue, and even stop periods.
  • High stress, excessive exercise, or very low body weight: These factors can switch your periods off completely, a condition called hypothalamic amenorrhea.
  • Adrenal gland problems: Issues like congenital adrenal hyperplasia or other adrenal disorders can raise male hormones and lead to extra hair growth, acne, or irregular cycles.
  • Some medications: Certain drugs, like steroids or hormonal treatments, can mimic PCOS symptoms.
  • Hyperprolactinemia: Raised prolactin levels from pituitary problems can stop periods and sometimes cause milky nipple discharge.
  • Cushing’s syndrome: A rare condition where too much cortisol is produced, leading to weight gain, acne, and extra hair growth.
  • Insulin resistance without PCOS: Some women have insulin issues causing weight gain, acne, or irregular cycles, but do not meet PCOS criteria.
When these conditions are overlooked, women may end up with a PCOS diagnosis that isn’t actually correct. This is why doctors look carefully at symptoms, tests, and lifestyle factors before labelling it PCOS.

What Harm Can a Wrong PCOS Diagnosis Cause?

A wrong diagnosis can be more than just inconvenient:
  • Women may stop using contraception because they believe they cannot get pregnant, leading to unplanned pregnancies.
  • Serious conditions like thyroid disease or hypothalamic amenorrhoea go untreated.
  • Many women experience unnecessary lifelong anxiety about fertility and overall health, worrying about problems that may not exist.
  • Some women make major life decisions based on fear, such as trying to conceive earlier than planned, changing career or personal goals, or even giving up on the idea of having children altogether.

Are All Women Diagnosed with PCOS at the Same Health Risk?

Not at all. Women who only have irregular periods and polycystic-looking ovaries (without raised androgens) do not carry the same higher risk of diabetes or metabolic problems as those who do have androgen excess.

The problem is that many patients aren’t aware of this distinction, which means a lot of women end up worrying unnecessarily about heart disease or diabetes, even though their actual risk is no higher than the average woman’s.

Is Weight Gain Always Caused by PCOS?

The relationship works both ways. Being overweight can make PCOS symptoms worse or even trigger them, but having PCOS doesn’t automatically make you gain weight or stop you from losing it. In fact, women with PCOS who follow the same diet and lifestyle plan as women without PCOS tend to lose about the same amount of weight.

So, if you’ve noticed weight gain, it’s not fair to blame PCOS alone. Focusing only on PCOS can actually slow you down from finding the real reasons behind it and getting the help that actually works.

How To Make Sure Your PCOS Diagnosis Is Correct?

Ask your doctor these simple but important questions:
  • Do I have at least two out of the three required markers?
  • Have other causes like thyroid problems, stress or adrenal issues been ruled out with proper blood tests?
  • Is the ultrasound report being considered on its own, or together with my symptoms and hormone test results?
PCOS misdiagnosis is more common than many realise, and being labeled with it when you don’t actually have it can cause unnecessary stress. If something feels off about the diagnosis you have been given, it is absolutely fine to ask for a second opinion. You deserve clarity, not confusion.

You’re not alone in your journey when trying to conceive. Join our supportive community to connect with others, share experiences, and find encouragement every step of the way.

FAQs on PCOS Misdiagnosis: When It Isn't Actually PCOS

  1. What is the best age to try to conceive if I have PCOS?
    The ideal age to try conceiving with PCOS is generally between 25 and 32 years, when fertility is usually at its peak.
  2. How can I tell when I am ovulating with PCOS?
    Ovulation can be tracked using basal body temperature charts or monitoring cervical mucus changes.

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