By Dr. Alexandra Roche, pediatrician specializing in adolescent medicine, and Dr. Marc Dadios, pediatric resident at CHOC Children’s
It’s normal for adolescents to go through physical and behavioral changes during puberty, but it can be difficult for parents to know when something may be cause for concern. Teen girls who experience irregular or missed periods may be suffering from Polycystic Ovary Syndrome (PCOS), a condition where a woman’s hormones become out of balance.
With PCOS, ovaries produce higher than normal amounts of hormones causing small cysts to form on the ovaries. These are generally not cancerous and don’t need to be surgically removed. Side effects include hair overgrowth and acne outbreaks. This condition frequently manifests during adolescence and can be associated with obesity. Women with PCOS may have an increased risk of developing type 2 diabetes, metabolic syndromes, cardiovascular disease and endometrial carcinoma. It is the most common cause of infertility in women.
What to expect during your doctor’s visit
If your doctor is concerned about your child developing PCOS, your doctor will order blood work to be checked before your next visit. Some of the blood work that your doctor will check are testosterone levels, estrogen levels, hormone precursors called DHEA levels, glucose levels, lipid levels, and cholesterol levels. Your child will also be asked to provide a urine sample as pregnancy, like PCOs, can be the cause of irregular or absent periods.
A treatment plan for PCOS includes management of the underlying metabolic abnormalities as well as reducing the risk factors for type 2 diabetes and cardiovascular disease. Diet and exercise changes for weight reduction will be recommended in cases associated with obesity, to prevent diabetes and help control hormonal imbalances in your child’s body. Hormonal therapy can help control hormonal imbalances caused by PCOS. Hormonal therapy is also known as oral contraceptives or birth control pills but those names can be misleading for the purpose of using these pills. The importance of using hormonal therapy is to normalize your child’s periods to prevent the development of endometrial cancer. Women who do not have periods for a long period of time are at increased risk of developing endometrial cancer.
What to expect next
If your child’s blood work shows evidence of hormonal imbalances concerning for PCOS your doctor will recommend diet, exercise, hormonal therapy, and close follow up. While PCOS can be a scary diagnosis to face, this condition can be effectively managed with a team effort between yourself and your doctor. Your pediatrician may refer your child to a pediatric endocrinologist for further specialty care.