Diagnosing PCOS in Teenagers

If you suspect that your teenage daughter might have PCOS, it is crucial to consult a doctor. Diagnosing PCOS is not based on a single test. Instead, doctors consider medical history, signs, symptoms, and test results.

The diagnostic steps may include:

• Examination of menstrual cycles: Onset and frequency.
• Family history: Looking for PCOS in relatives.
• Signs of early puberty: Onset before age 8.
• Clinical signs: Such as acanthosis nigricans and excessive hair growth.
• Weight monitoring: Excessive weight gain is common with PCOS.
• Blood tests: To check cholesterol, sugar, and insulin levels, which are often elevated in PCOS patients, and to rule out other hormonal issues.

Diagnosing PCOS in teenagers is complex because their bodies and hormones are undergoing significant changes. Some symptoms may simply be related to puberty rather than the syndrome. Doctors look for a history of irregular periods and signs of elevated androgen levels. Sometimes, the diagnosis is only confirmed when the girl is older and has had her period for several years.

The Evolution of PCOS Over the Years

PCOS does not manifest the same way at all ages. Here’s how it generally evolves:

• At 15 years: Ovulation disorders and acne. During puberty, the first signs of PCOS are often irregular menstrual cycles, severe acne, and excessive hair growth. These symptoms are often interpreted as normal hormonal changes of adolescence.

• At 25-30 years: Infertility and hyperandrogenism. PCOS is often diagnosed at this age when women face difficulties conceiving. Fertility issues lead to comprehensive examinations, revealing the presence of PCOS. The syndrome also increases the risks of pregnancy complications, such as preterm births and gestational diabetes.

• At 45 years: Insulin resistance and pre-diabetes. As menopause approaches, symptoms of hyperandrogenism and ovulation disorders tend to decrease, giving way to metabolic complications. PCOS can then lead to insulin resistance, carbohydrate intolerance, and pre-diabetes, often marked by significant weight gain.

• At 55 years: Diabetes and cardiovascular risks. Around age 55, PCOS increases the risk of metabolic syndrome, type 2 diabetes, endometrial cancer, and cardiovascular diseases. Patients with a high body mass index are particularly at risk. Metabolic syndrome is diagnosed based on several criteria, including a waist circumference over 80 cm, type 2 diabetes, hypertension, high triglyceride levels, or low HDL cholesterol.

Management and Treatment of PCOS in Teenagers

Hormonal imbalances due to PCOS can lead to obesity and insulin resistance, increasing the risks of diabetes and heart disease in the long term. If left untreated, PCOS can also make conception more difficult. Teenagers with PCOS or at risk can manage symptoms and hormonal effects with lifestyle changes and medications.

Measures to manage PCOS include:

• Healthy diet and exercise: To lose weight.
• Treatment of acne or excessive hair growth: With medications or cosmetic dermatology procedures.
• Medications: To manage blood sugar levels or balance sex hormones.
• Management of anxiety or depression: Often caused by PCOS.

It is also crucial for girls with PCOS who are sexually active to discuss contraception with their doctor. Although PCOS interferes with ovulation and causes irregular periods, they can still become pregnant.

For information on treatments for PCOS at all ages, our blog post is available here.

Conclusion

Increased awareness of PCOS in young girls is necessary. PCOS can occur at an earlier age in girls with early pubarche and thelarche. Therefore, diagnosing and evaluating PCOS should be considered for young girls with risk factors. By being proactive and making healthy lifestyle choices, young girls can effectively manage PCOS and reduce its long-term impacts.