PCOS: Early Signs To Look Out For In Teenagers And Steps That Follow

Polycystic Ovary Syndrome (PCOS) is a prevalent hormonal disorder affecting adolescent girls, often emerging during puberty. Recognizing early signs and implementing timely interventions can significantly impact long-term health outcomes. This guide delves into the early indicators of PCOS in teenagers and outlines effective treatment and management strategies. PCOS is characterized by hormonal imbalances leading to irregular menstrual cycles, elevated androgen levels, and polycystic ovaries. In adolescents, the onset of PCOS symptoms can coincide with the natural changes occurring during puberty, making early detection challenging. In this article, we understand early signs, diagnostics and management tips for teenagers.

Early signs of PCOS in teenagers

1. Irregular menstrual cycles

Adolescents with PCOS often experience menstrual irregularities such as delayed onset of menstruation, infrequent periods, or heavy bleeding. These irregularities may persist for several years post-menarche. Notably, a study indicated that PCOS was the most common underlying cause of abnormal uterine bleeding in adolescents.

2. Hyperandrogenism symptoms

Elevated androgen levels can manifest as excessive hair growth on the face, chest, or back. It can also persistent and severe acne, often resistant to standard treatments. Thinning of hair on the scalp, leading to noticeable hair loss is another common sign. These symptoms are indicative of hyperandrogenism and may be among the first signs of PCOS in adolescents.

3. Obesity and insulin resistance

A significant number of adolescents with PCOS may exhibit obesity and insulin resistance. These metabolic disturbances can exacerbate hormonal imbalances and increase the risk of developing type 2 diabetes later in life.

4. Mood disorders

Adolescents with PCOS are at a heightened risk for depression and anxiety. A study found that these individuals experienced more severe depressive symptoms compared to their peers without PCOS.

Diagnostic approach

Diagnosing PCOS in teenagers requires a comprehensive evaluation:

1. Clinical assessment

Detailed medical history and physical examination to identify symptoms like hirsutism, acne, and menstrual irregularities.

2. Laboratory tests

Measurement of serum testosterone and dehydroepiandrosterone sulphate (DHEAS) levels to assess hyperandrogenism.

3. Ultrasound imaging

While polycystic ovarian morphology (PCOM) is common, it should not be used as a sole diagnostic criterion in adolescents.

It's crucial to differentiate PCOS from other conditions with similar presentations, such as thyroid disorders or hyperprolactinemia.

Management strategies

Effective management of PCOS in adolescents focuses on symptom control and prevention of long-term complications:

1. Lifestyle modifications

• Diet: Adopting a balanced, low-glycemic diet can help manage insulin resistance and support weight management.
• Physical activity: Regular exercise improves insulin sensitivity and aids in weight control.
• Sleep hygiene: Ensuring adequate and quality sleep is vital for hormonal balance.

2. Pharmacological interventions

• Oral contraceptive pills (OCPs) are used to regulate menstrual cycles and reduce symptoms of hyperandrogegism.
• You may also be prescribed metformin as it improves insulin sensitivity and can aid in regulating menstrual cycles.
• Anti-androgens medications can reduce symptoms of hirsutism and acne.

3. Psychological support

Addressing mental health is crucial, as adolescents with PCOS may experience self-esteem issues, depression, and anxiety. Psychological counselling and support groups can be beneficial.

4. Long-term monitoring

Regular follow-up is essential to monitor for potential complications such as type 2 diabetes, endometrial cancer, and fertility issues. Transitioning care from paediatric to adult healthcare providers should be planned to ensure continuity.

Early identification and management of PCOS in teenagers are vital to mitigate long-term health risks. Through a combination of lifestyle changes, pharmacological treatments, and psychological support, adolescents with PCOS can lead healthy, fulfilling lives. Collaboration between healthcare providers, patients, and families is key to effective management.

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for a qualified medical opinion. Always consult a specialist or your doctor for more information. NDTV does not claim responsibility for this information.

References

International evidence-based recommendations for polycystic ovary syndrome in adolescents. BMC Medicine, (2025). 
Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Journal of Clinical Endocrinology & Metabolism, (2023).
Polycystic ovary syndrome in adolescents: Challenges in diagnosis and treatment. International Journal of Endocrinology and Metabolism, (2019). 
Treatment and complications of PCOS in adolescents. Frontiers in Endocrinology, (2024). 
Adolescent polycystic ovary syndrome according to the international evidence-based guideline. BMC Medicine, (2020)
Polycystic ovary syndrome: Pathophysiology, presentation, and treatment with emphasis on adolescent girls. Journal of the Endocrine Society, (2019).