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July 8, 2024

Understanding Polycystic Ovary Syndrome (PCOS) in Adolescent Girls: Symptoms, Early Diagnosis and Management Strategies

Much has been talked about PCOS over the last few years. The internet is abuzz with the subject, with people offering solutions and remedies for curing and dealing with the disease. Unfortunately, not all advice is correct and some may be outright harmful.

Unfortunately, in many cases, polycystic ovary syndrome may start very early on, right from the adolescent stage. In fact, it has been estimated that almost 1 out of 10 girls suffer from this syndrome.

In such a situation, having the right kind of information can be empowering.

Let’s embark on a journey to understand adolescent polycystic ovary syndrome with this article and explore all that you should know about this disease so that you can help your little girl deal with it.

What is Adolescent Polycystic Ovary Syndrome?

Polycystic Ovary Syndrome or PCOS is a hormone imbalance where the ovaries produce a high amount of male hormones such as testosterone. Usually, the ovaries produce very small amounts of these hormones. However, in PCOS excessive amounts may be produced. This can lead to issues such as irregular periods, acne and unwanted hair growth.

This is one of the most common issues faced by women of reproductive age. It can start as early as 15 years of age.

Causes of Adolescent PCOS

The exact causes of PCOS are still not clear, but mostly it is related to the imbalance of hormones. While both females and males produce sex hormones, the amounts are different between the two genders. In females, the ovaries mostly make the hormones oestrogen and progesterone and small amounts of androgens such as testosterone. The small glands located on the top of each kidney, adrenal glands, also make androgens. All these hormones together regulate a girl’s ovulation and menstrual cycle.

While androgens are mostly considered male hormones, the female body also makes them. For a girl suffering from PCOS, the body makes excessive amounts of androgens. However, the exact cause of this secretion is yet not identified.

PCOS can be hereditary. So, if someone in the family has it, others may develop it too.

The Physiological Effects of PCOS

So what happens to the body when one has PCOS?

Higher amounts of androgens secreted during PCOS can interfere with the entire ovulation process. It can hamper the development and release of eggs. Multiple cysts may develop on the ovary which can hamper the normal functioning of the ovary. Hence, during PCOS, the ovary may not ovulate or release an egg each month. This is why girls with PCOS experience irregular periods or even miss cycles. Girls with PCOS may have trouble getting pregnant later on.

Hence, it is important to treat PCOS on time.

Symptoms of PCOS in Adolescents

The primary sign of PCOS in teens is missed or irregular periods. It is usually not diagnosed 2 to 3 years after a girl gets her first periods as it generally takes 2 to 3 years for a girl’s periods to regularise.

The imbalance of hormones during PCOS may lead to other symptoms such as:

  • Clogged pores or acne
  • Very heavy or very light periods
  • Thinner hair on the head. This condition is known as alopecia.
  • Weight problems, mostly weight gain and obesity. Usually, the extra weight is accumulated around the waist.
  • Dark patches and thickened skin on the neck, armpits or between breasts. This is a sign of insulin resistance.
  • Unwanted hair growth especially on the face, hands, upper arms, chest, abdomen, back, legs or around the nipple. This condition is known as hirsutism.
  • High cholesterol, high blood pressure and high blood sugar levels.

In general, girls who show signs of puberty (such as developing pubic hair or underarm hair) before the age of 8 are at a higher risk of developing PCOS later on.

When to Consult a Doctor

As a parent, it can be difficult to understand when to seek a doctor’s advice, because having irregular periods is not uncommon, especially in teenagers.

So, when should you go to a doctor?

If your child has two or more of the above symptoms, then it could be PCOS. However, remember it does not necessarily mean that it is PCOS. The above symptoms can be due to other reasons as well. The best way to find out is by meeting a general practitioner and seeking advice. Your doctor may ask you certain questions to determine the cause of the symptoms.

After an initial evaluation, the general practitioner may recommend you to a gynaecologist or an endocrinologist.

Here are some of the things to remember regarding your doctor’s visit:

  • Write down questions you have in your mind before visiting your doctor. This can help you have a more fruitful discussion and help in clearing your doubts.
  • Listen to what the doctor has to say, and take notes if required. If your doctor recommends a nutritionist, another doctor or any other person who can help your child, write down the details.
  • Write down the dates of follow-up appointments and the purpose of the visit.
  • Always find out what to do in case of any emergency, before you leave the appointment.

What Happens if PCOS is Left Untreated?

PCOS can lead to serious health problems if left untreated. Teenagers with PCOS are at an increased risk of developing high blood pressure, type 2 diabetes, problems with blood vessels and heart and uterine cancer. Girls with PCOS also have a higher tendency to have difficulties getting pregnant.

Diagnosis of PCOS

If your general physician suspects that your daughter has PCOS, they may recommend you to an endocrinologist or a gynaecologist. Doctors use a variety of tests if they suspect that your daughter has PCOS. First, they will check her height, weight and blood pressure. The doctor may ask you questions about your daughter’s health such as the regularity of the menstrual cycle, her medicine schedule and whether there’s a family history of PCOS.

The doctor may also conduct additional tests such as blood tests to check her blood glucose, cholesterol and hormone levels. They may also conduct a pelvic ultrasound test of the ovaries and uterus if they deem fit. Don’t worry, the test is completely painless.

Treatment of PCOS in Teens

Unfortunately, there’s no cure for PCOS. However, certain things can have a long-term effect on its management. These include:

Lifestyle changes

Living a healthy lifestyle can have a lasting impact on girls living with PCOS. Eliminating sugary foods and drinks and getting regular exercise can help. Opt for home-cooked food rather than eating out often. Avoiding junk food can be helpful as well. Having an effective exercise regime can be helpful too. It can help your teen deal with insulin resistance and prevent the onset of diabetes.

Meeting a registered dietician

Meeting a registered dietician can help you understand the dos and don’ts of food about your girl. A dietician can also help you gain knowledge about different foods so that you can help your child deal with hormone imbalances such as insulin resistance.


Your doctor may prescribe medicines for your girl to regulate periods, control acne and use insulin better. The doctor might prescribe pills to control androgen levels and thus regulate their menstrual cycle. Such medicines can also help control acne and excessive hair growth. However, it takes six months for such pills to take effect.

Doctors might also use antiandrogens to treat PCOS. They are used to counter the effects of excess androgens, which in turn, can also help clear up acne and hair growth problems. Sometimes a diabetes medicine metformin can be prescribed to lower insulin levels. This can help control androgen levels and ovulation, thus making menstrual cycles more regular. Medicines and lifestyle changes should work in tandem to make life easier for your girl.

Hair removal treatment

While your doctor and dietician can help your child deal with the disease, as parents you can help her if she has concerns about her appearance. Unfortunately, PCOS hits at an age when girls start to get conscious about their appearance. Opting for hair removal treatment such as waxing, bleaching, shaving, medications or laser treatment can be very helpful.

How You Can Help Your Child

Keeping the practical aspects aside, helping your daughter who has been diagnosed with Polycystic Ovary Syndrome (PCOS) can be challenging. However, this is the time she needs you the most. It will take more than support from you; you need to be equipped with a whole lot of information and shower her with lots of love to make this journey smoother for him.

It is important to know that PCOS is a hormonal condition that affects 1 out of 10 women, many of whom are in their teens. So, your child needs to know that she is not alone, many girls are going through the same issue.

Although many girls experience the same thing, PCOS can have different impacts on different people. Hence, it is important to tailor the strategy based on the issues that a girl is facing. A personalised approach can go a long way in making life easier for your little girl.

Here are some of the things you can do to help your child, or any girl around you who you know is going through this issue.

Emotional support

Your girl may get frustrated from time to time, dealing with PCOS. It is important to lend a patient ear to her and validate a feeling. Create a supportive environment for her, so that she feels comfortable sharing her feelings. Emotional support forms a big part of helping your child deal with the condition.

Form a team

Make a team between you, your child and her doctor. It is very important to trust your doctor and believe the treatment is going the right way.

Tailor her lifestyle

Leading a healthy lifestyle is an essential aspect of dealing with PCOS. A balanced diet, regular exercise and good sleep habits can help her manage PCOS symptoms. This will make her feel happy about her body as well, which in turn, will raise her self-confidence.

Follow stress-management techniques

Your girl might go through a significant amount of stress while dealing with PCOS and its symptoms. Consider stress management techniques such as deep breathing and relaxation. Stress can worsen PCOS symptoms.

Learn, learn, learn

Knowledge is power. This is true about PCOS too. Equip yourself with sufficient knowledge about PCOS. A lot of information is available online about the condition and its impact on adolescents. Read and learn as much as you can, the more knowledge you have, the more you will be able to help your child.

Empower your Child

Empower your child so that she can take charge of her own health and deal with her own PCOS. You can also help her connect with other girls who are dealing with the same issue. This can help your girl get a support group where girls can share the journey. Sharing things with girls of their own age can be very helpful.

A Final Word

We understand that being diagnosed with PCOS is a difficult time for your girl, and for you too. A little bit of love and support can go a long way in manoeuvring this journey. Make sure to let your child know that you are in this together. Working as a team can make this journey easier for everyone in the family.

Require expert advice or specialized treatment? Please arrange an appointment with our specialist.

Dato’ Dr Zamri Abdul Rahim
Consultant Obstetrician, Gynaecologist & Reproductive Medicine

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