PCOS(Polycystic ovary syndrome): PCOS in Adolescence

By Dr. Gayatri Deshpande in Gynaecology & Obstetrics

Apr 24 , 2023 | 2 min read

Polycystic ovary syndrome (PCOS) is a common female reproductive disorder that often manifests during adolescence and is associated with disruptions in health-related quality of life. It had been so far considered to be a disease of adult females presenting with infertility. In recent times though, with industrialisation and stressful urban lifestyle, we are increasingly finding young adolescent girls presenting with PCOS.

Diagnosing PCOS during adolescence however, can be quite challenging because features of normal puberty may overlap with adult PCOS diagnostic criteria. The clinical presentation of an adolescent who could be having an underlying PCOS are :- irregular/infrequent menses for more than 2 years after starting her periods (menarche), excessive body hair called hirsutism, severe acne and/or obesity. These girls are also at a higher risk of insulin resistance and diabetes. If not managed in adolescence, PCOS can lead to infertility issues. Mood disturbances are common among adolescent girls with PCOS and have been the subject of recent research.The propensity for obesity and cosmetic concerns (eg, hirsutism, acne, etc) may lead to poor self-esteem and depression. On clinical suspicion of adolescent PCOS, further management may be guided by certain hormonal blood tests.

Because PCOS in adolescence can have lifelong implications for metabolic and reproductive health, early treatment is critical. The goals of treatment include decreasing the risk of endometrial cancer, managing irregular menses, reducing hirsutism and acne, decreasing the risk for development of type 2 diabetes, reducing cardiovascular risks, improving quality of life, and preserving fertility.

PCOS is a common diagnosis but is far from "one size fits all" with respect to treatment. Optimal treatment uses a multimodal approach, including nutrition and exercise interventions in adolescents. Lifestyle modification involving a healthy nutritious diet and daily moderate to vigorous exercises to ensure weight loss is strongly recommended. This can help to prevent progression into adult PCOS that may also affect fertility. Some adolescents with PCOS may require medications to control their obesity and overcome hormonal changes, under supervision of an Adolescent Health Specialist.

Thus, we see that PCOS is a modifiable life-style disease that needs long-term individualised management, under specialist supervision. Prompt evaluation and clinical support after diagnosis may prevent associated complications, potential long-term cardiovascular, metabolic, and reproductive health issues and optimize overall health management.

Reviewed By

Dr. Gayatri Deshpande (Sr Consultant - Obstetrics & Gynaecology)

Dr. Gayatri Deshpande, Senior Consultant, Gynaecology and Obstetrician, and Robotic, Laparoscopic Surgeon Nanavati Max Super Speciality Hospital has an experience of over 20 years. She has been practicing Gynaecological Laparoscopy since 19 years and has performed more than 5000 Laparoscopic surgeries. She is one of the handful robotic gynaecological surgeon of Mumbai and has performed thousands of successful surgeries.