Gaining a Better Understanding of PCOS

Published on: 09/20/2021

By Adriana Carrillo Iregui, MD

Medical Director of the Diabetes Program

About Dr. Carrillo

Polycystic ovary syndrome, or PCOS, is a common but poorly understood disease that impacts many teenagers and young women during their reproductive years. Each year, the National Polycystic Ovary Syndrome Association seeks to raise awareness and increase understanding of this condition by naming September PCOS Awareness Month. With that in mind, here are a few facts you should know about identifying and treating the different types of PCOS based on my research and clinical experience.

It's More Common Than You Think

The first thing to know about PCOS is that is a common condition in adolescents. Many teens and even young girls begin to exhibit signs of the condition even before menstruation. Overall, 5 to 10 percent of all women will experience the condition, often before the age of 30.

The Different Presentations of PCOS

PCOS can be overlooked, as it can present different in adolescents. The term PCOS is a term for a variety of symptoms associated with common hormone changes. Some of the factors that can contribute to PCOS include:

  • Too much insulin – The primary hormone that is often involved with PCOS is insulin. Higher insulin levels can lead to overproduction of a hormone call testosterone causing irregular cycles and metabolic changes, which increases risk for diabetes and later in life, cardiovascular disease.
  • Excess androgen –Can also cause symptoms such as excess facial and body hair, acne, and other similar symptoms.
  • Inflammation – The hormonal changes related to PCOS put your body on high alert, which leads to low-grade inflammation that can further contribute to symptoms.
  • Other factors – In some cases, other factors such as genetics and medications you are taking may also play a role in the development of PCOS.

The Varying Symptoms of PCOS

Considering the interplay of all these factors, it's understandable that PCOS can look a lot different from person to person. Some teenage girls and young women may exhibit one or two of these symptoms, while others may experience several of them:

  • Unusual or irregular periods – According to The American College of Obstetricians and Gynecologists (ACOG), those with PCOS may experience symptoms ranging from infrequent or missed periods to very frequent or heavy periods.
  • Obesity – Many girls have increased body mass index (weight kg/Htcm2).
  • Unusual hair growth – Growth of hair on the chest, abdomen, face, or upper thighs can also occur with PCOS. 
  • Acne or oily skin – Oily skin and acne with PCOS can sometimes grow severe.
  • Ovarian cysts – are not part of the diagnosis in adolescents and changes in ovaries are more related to slighter larger ovarian size.

PCOS is a diagnosis of elimination and determined to be after an extensive evaluation as some of the symptoms such as irregular menstrual cycles and acne can be part of a normal process in adolescents.

Individualized Treatment Is Key

Since PCOS manifests itself so differently, I have found that individualized treatment is very important in helping teenage girls and young women manage their specific symptoms. One thing that seems to help many with PCOS is weight loss. The Mayo Clinic notes that even a modest reduction of 5 percent in weight can dramatically reduce PCOS symptoms. Bariatric surgery when indicated in adolescents might help to resolve this condition.

Other treatments for PCOS are to regulate hormone levels including birth control pills, progestin meds, insulin sensitizers such as metformin. Depending on your symptoms, other medications may be prescribed that can help decrease excessive hair growth or acne.

Ultimately, being properly diagnosed and treated for PCOS takes close consultation with your trusted health care provider. Be sure to schedule an appointment if you think that PCOS is contributing to the symptoms that you or your teenager are experiencing.

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