Helping Teenagers with Polycystic Ovary Syndrome
Polycystic Ovary Syndrome (PCOS) is extremely complex. It affects an estimated 4 to 8 percent of women of reproductive age between adolescence and menopause and results from the excessive production of androgens from the ovaries and metabolic changes that can become more severe with weight gain. Females may suffer from one or many of a variety of symptoms which include:
- acne,
- weight gain,
- extra hair on faces and bodies,
- skin changes,
- thinning hair on the scalp,
- irregular periods, and
- ertility problems.
Research
Until recently, PCOS research has tended to focus on adult women and their challenges with infertility, but teenage girls can also be affected with PCOS. The focus of research studies has now started to shift towards adolescence which is when the syndrome begins and when the prevention of complications is likely to be more effective.
A Unique Clinic
A year ago, Josephine Kasa-Vubu, M.D., M.S., Associate Professor, Department of Pediatrics and Communicable Diseases, and Research Investigator, Institute for Research on Women and Gender, University of Michigan Health System started a unique clinic for adolescent girls with PCOS. As a former NIH Building Interdisciplinary Research Careers in Women's Health Scholar, Dr. Kasa-Vubu also has broad expertise in the areas of puberty and obesity that fuels her interest in this condition. The focus of the Teen PCOS clinic is to promote earlier diagnosis in very young women whose symptoms may not have reached the magnitude seen in older patients. The mission of the clinic is to help girls address both their metabolic and androgen abnormalities with an approach that is relevant to their own goals and stage of maturation.
The origin of PCOS is not known. It is suspected, but not proven, that some women affected with this condition may have a genetic predisposition.
Symptoms
What symptoms could become cause of concern for possible PCOS in a teen girl?
- 1. A lack of periods.
The majority of healthy girls in the United States have started menstruating by age 13, if they are not involved in competitive sports. If a teenage girl who is not underweight and is physically developed has not started menstruating by age 14, it may be a sign of PCOS. - 2. Irregular periods.
Many teens with PCOS report starting their periods early but then have not been able to have predictable periods after several years. Irregular periods can be of concern if there are fewer than nine periods a year or if they are spaced out more than 41 days. During puberty is takes time for the body to mature and periods may not be regular for the first couple of years which further complicates diagnosis. If periods are still irregular after more than two years , this may be a sign of PCOS. - 3. Excessive acne that is hard to control, particularly if there are irregular periods.
- . Very rapid weight gain while the body is changing during puberty along with irregular periods more than two years after having experienced the first one. Many patients start having darkening of the skin around the neck and sometimes skin tags.
- 5. Excess body hair on the face, sideburns, chest, below the navel line or between the thighs in the back. If the hair is very fair, it might not be as noticeable.
Linked to Obesity
PCOS is closely tied to obesity. Metabolic abnormalities tend to emerge when people become overweight. Many girls begin puberty while they are already overweight and they are anticipated to gain weight twice as fast the girls the same age who are lean. Most of these girls will go on to be healthy teens even if they are larger than average. Dr. Kasa-Vubu points out that the increase in sedentary lifestyles and obesity issues in adolescent girls can exaggerate the pace of weight gain during puberty which is a favorable setup for PCOS symptoms to emerge in girls who are at risk. She says parents of girls with PCOS are often convinced the syndrome is an entity separate from weight issues. Dr. Kasa-Vubu says, "Exaggerated weight gain is one aspect of the same issue and weight control is part of the solution." In the initial steps of managing the metabolic problems of PCOS, stabilizing the weight gain is part of the strategy.
Thin girls can still have PCOS symptoms even though they may have more of a tendency to accumulate fat around the waist or in internal organs in ways that may not be visible without investigation. So even if their weight is normal, their metabolic health is similar to that of teens who are a lot heavier. In teens with PCOS who exercise often, the symptoms are often much milder and the absence of periods might be misdiagnosed as result from exercise.
PCOS is mostly known as a fertility problem but it represents a broader health hazard for teens and young women. While most teen girls are not focusing on fertility, it is important to recognize and treat PCOS early because it represents a greater long-term risk for gestational diabetes, type 2 diabetes, hypertension and heart disease as they move on to become adults.
Find out more about the dPediatric Endocrinology, Diabetes, and Metabolism Clinic, call 734-764-5175.
prepared for the Women's Health Progam web site 11/09
