By Agbai Sharonjoyce
Polycystic Ovary Syndrome (PCOS) is a common hormonal condition that affects many young women. It occurs when the ovaries produce higher-than-normal levels of androgens (male hormones).
Identifying PCOS in adolescents aged 10 to 19 can be very difficult because many normal puberty changes look similar to PCOS. This is why international guidelines stress careful and accurate diagnosis to prevent delays or misdiagnosis.
Early symptoms
Parents, guardians and teenagers should pay close attention to certain physical changes.
Although menstrual cycles can be unpredictable for the first few years after a girl begins menstruating, ongoing issues may signal a problem. This includes skipping periods, heavy bleeding or cycles longer than 45 days. Also, if a period occurs once or twice every six months, a thorough medical checkup is highly recommended.
Excess androgens can cause noticeable changes such as excessive hair growth (hirsutism) on the face, chest or stomach.
Also severe acne, particularly around the lower face and jawline. High levels of androgen can also lead to thinning hair on the scalp (similar to male baldness).
Many adolescents with PCOS often struggle with weight gain, particularly around the stomach. Some also develop dark, velvety skin patches (acanthosis nigricans) on the neck, armpits or other folds—an indication of insulin resistance which is associated with PCOS.
Why misdiagnosis is common
Diagnosing PCOS too early or incorrectly is a major concern. Puberty naturally brings changes like acne and irregular periods, and these can easily be mistaken for PCOS.
Misdiagnosis can cause unnecessary worry and emotional stress. It’s important to note that some diagnostic tools used for adults should not be used in young teens:
Pelvic ultrasounds: Not recommended for those who have menstruated for less than eight years because adolescent ovaries naturally appear “polycystic.”
Anti-Mullerian hormone tests: Levels vary widely among healthy teens, so this test alone cannot confirm PCOS.
The right diagnostic approach
An accurate diagnosis for adolescents involves excluding other medical conditions that can produce similar symptoms, such as thyroid problems or congenital adrenal hyperplasia.
If a teenager shows some symptoms but does not meet all the diagnostic criteria, she may be classified as at risk of PCOS. This allows doctors to manage symptoms—such as irregular menstruation or excess hair growth—without assigning a firm diagnosis too early.
Reassessment is essential; a follow-up evaluation is recommended three years after menarche (first period occurrence) to review the menstrual patterns, and an ultrasound should be considered only eight years after menarche to assess ovarian morphology. This approach helps prevent both delayed and premature diagnosis.
Recommendation
Lifestyle modification is the most important first step to managing PCOS. This includes healthy eating, regular exercise and behavioural strategies to maintain a moderate weight.
However, due to the high rate of anxiety and depression among girls living with PCOS, regular screening for these emotional issues should be done in adolescents who have been diagnosed.
Proper diagnosis, management and support are very important to assist teens go through this condition and improving their long-term health outcomes. Early diagnosis is important to start effective treatment and avoid unnecessary damage.
Summary not available at this time.
