Polycystic ovary syndrome (PCOS) is an endocrine disease that causes an imbalance of reproductive hormones in teenage girls and young women. This imbalance creates problems in the ovaries, making it difficult to make and release eggs during ovulation.
Adolescents with PCOS may face irregular periods, heavy menstrual flow, absence of periods, excess hair or acne on the body, and other metabolism problems. Problems with the menstrual cycle may further lead to infertility and cysts in the ovaries. These cysts are not cancerous and need not be removed with surgery (1) (2).
Read the post to know about PCOS in teens, its causes, symptoms, diagnosis, treatment, and effective ways to cope with it.
Is PCOS Common In Teenagers?
PCOS is a common condition, affecting around 5% to 10% of teenagers and young women between 15 and 44 (2).
The exact worldwide prevalence of PCOS is unknown but is believed to range from 2.2% to 26%. In a few Asian countries such as China and Srilanka, the prevalence rates are 2% to 7.5% and 2% to 6.3%, respectively (3).
What Causes PCOS In Teens?
The exact cause of PCOS is unknown, but experts assume genetics and hormone imbalance might play a role.
Ovaries produce sex hormones such as estrogen, progesterone, and small amounts of male hormones called androgens (testosterone). Androgens are also produced by adrenal glands located on the top of each kidney. Normal levels of these hormones regulate the ovulation and menstrual cycle.
In women with PCOS, the body starts making more than normal androgen levels, which interfere with egg development and ovulation. Since ovulation does not take place properly, ovaries become enlarged and develop small cysts. These cysts produce more androgens that interfere with ovulation and menstrual periods and cause acne problems and extra hair growth (4).
Apart from this, it has also been found that PCOS may cause adolescent girls to develop insulin resistance (body cells don’t respond properly to insulin). So, the insulin level in the body rises above normal and, in turn, causes the ovaries to produce more androgens (1) (2).
What Are The Symptoms Of PCOS In Teens?
Teenage girls with PCOS may experience one or more of the following symptoms (1).
- Irregular periods (adolescents may experience missed periods, fewer periods, or frequent periods)
- Pelvic pain (5)
- Hirsutism (a condition where girls have excess hair growth on the face, chest, abdomen, and other body parts)
- Severe acne and clogged pores
- Weight gain, difficulty in losing weight, or obesity (having extra weight around the waist)
- Dark and thick skin on the back of the neck, armpits, or breasts due to insulin resistance (a condition called acanthosis nigricans)
- Skin tags (extra hanging skin) on armpits and neck area
- Thinning hair (alopecia)
What Are Risks And Complications Of PCOS?
- Family members with PCOS (mother, sister, or aunt)
- Early-onset of puberty in girls (before the age of eight)
It has been found that PCOS may lead to other health complications in the future such as (2):
- More than half of the girls may develop diabetes or glucose tolerance (prediabetes) before 40.
- High blood pressure later in their lives.
- High levels of cholesterol.
- Some girls with PCOS, who also have obesity, may develop sleep apnea.
- Depression and anxiety.
- Problems with ovulation, obesity, and insulin resistance may increase the risk of developing endometrial cancer.
- Difficultly in conception.
How Is PCOS Diagnosed?
To diagnose PCOS accurately, your doctor may want to know about your daughter’s medical history, medications, menstrual cycle pattern, and history of any family member having the same condition. The doctor will also perform the following tests, where different parameters will be checked. (2) (6):
1. Physical examination:
- Weight, body mass index, and waist size
- Signs of extra hair on the body
- Signs of severe acne
- Signs of hair loss
- Patches of dark skin
- Any other sign of health problems, such as enlarged thyroid
2. Pelvic examination:
- Extra male hormones
- Enlarged or swollen ovaries
3. Pelvic ultrasound:
4. Blood tests:
- Hormone levels
- Blood sugar levels
- Cholesterol levels
How Is PCOS Treated In Teens?
There is no cure for PCOS; however, it can be addressed successfully with lifestyle modifications, diet, and medications.
1. Regular exercise: Exercise has a positive impact on the endocrine system because it helps in weight loss. Studies show that even a 5% reduction of body weight in anybody who is overweight may help eliminate some PCOS symptoms.
2. Nutritious diet: A nutritious diet helps lose weight, regulate insulin levels, and keep the heart healthy. Teenagers should consult doctors and nutritionists for diet-related suggestions. Some simple diet rules to follow are:
- Include high-fiber carbohydrates in the diet
- Add proteins and healthy fats to the diet to balance carbohydrates
- Eat smaller meals and include healthy snacks
3. Treating excess hair growth: Excess body hair may be treated with electrolysis, laser treatment, waxing, bleaching, or depilatories. Prescription medications such as Spironolactone may also be used to help reduce hair growth and make the hair finer.
4. Treating acne: Acne may be treated with topical creams, birth control pills, and oral antibiotics. However, studies show that when insulin and blood glucose levels are controlled, ovulation regularizes, and acne issues improve.
5. Birth control pills: Birth control pills balance the hormone levels; therefore, a healthcare provider prescribes them to teenagers even if they are not sexually active. Ways in which birth control pills help are:
- Lowers the level of testosterone
- Regulates menstrual cycle
- Lowers the risk of endometrial cancer
6. Other options:
- Metformin is a medication given to girls who are pre-diabetic, diabetic, or have high levels of insulin. However, it is important to consult a doctor before using it. They should get a blood test done to check kidney and liver functions and also avoid alcohol.
- Antiandrogens are also used to treat PCOS in some adolescent girls. These medications lower androgen levels and help prevent unwanted hair growth. However, these are not approved by the Food and Drug Administration and may cause problems in pregnancy.
- Hormonal therapy, including skin patches, vaginal rings, and hormonal intrauterine devices, may also treat PCOS.
How To Cope With PCOS?
It might be overwhelming for teen girls to deal with the different symptoms that come along with PCOS. Some ways which may help your teenagers include (1) :
- Find a doctor who has good knowledge about the condition.
- Encourage your daughter to share all her worries and concerns with the doctor.
- Help your daughter find a nutritionist who would suggest proper diet plans to control the condition.
- Stress on the importance of taking medications regularly. These medications may help reduce future risk of having diabetes or other health issues.
- Encourage your daughter to stay away from smoking and alcohol.
- Help your daughter make small changes in her diet and exercise routine.
- Include lots of fruits, vegetables, whole grains, and other healthy foods in your daughter’s daily diet.
- Talk to the doctor about the best ways to remove extra body hair.
It could be worrying for teenage girls to get diagnosed with PCOS. The different symptoms associated with the condition may also cause anxiety and depression in some girls. However, it is important to know that PCOS is common among teenagers and can be effectively managed with a healthy lifestyle and positive attitude. Encourage your daughter to build a support group to share her concerns. Sharing her thoughts will enable her to understand the condition better and keep her comforted.