Diagnosis Of Polycystic Ovary Syndrome (PCOS) In Adolescence

According to BMC Medicine, 6-8% of adolescent girls have polycystic ovary syndrome (PCOS). PCOS is a common cause of infertility in women. Most women don't realize that they have PCOS until later in life when they're trying to conceive. 

Adolescent girls can experience various gynecological health problems no matter their age. Doctors have noticed an increase in PCOS in young girls. Unfortunately, a diagnosis of PCOS in adolescents can be challenging. 

You can find help if you or someone you love has been diagnosed with PCOS as a teenager. This guide will discuss everything you need to know about PCOS diagnoses for adolescents. 

Symptoms of PCOS in Teens

The symptoms of PCOS in teens are similar to that of older women. It's essential to pay attention to all PCOS symptoms you or your loved one might be experiencing. PCOS might get overlooked if the main symptom is irregular periods since that can be a normal occurrence for teenage girls. 

Irregular Periods

According to TeensHealth, it's normal for a teenage girl to have irregular periods or skip them entirely. The average girl gets her first period around 10 to 15 years old. Some girls might get it earlier or later. 

The typical cycle length for a young girl or woman is 28 days. A girl who recently got her first period might notice that her cycle varies in length each month. It should level out after the first few years. 

The length of a girl's period can also vary. Sometimes her period might last for two days. During other cycles, it might last for seven days. 

The length of her period might fluctuate because of her hormone levels. You should pay attention to the following symptoms if you're having an irregular period:

  • Your period stops 
  • Your cycle was regular and became irregular 
  • Your periods last longer than a week and are heavy
  • Your cycle is less than 21 days
  • Your cycle lasts longer than 45 days

If you're experiencing any of the above symptoms, you should make an appointment with your healthcare provider. 

Abnormal Hair Growth

According to Texas Children's Hospital, hirsutism is a health condition characterized by excessive hair grows in abnormal areas. PCOS often causes hirsutism. That's because PCOS disrupts a girl's hormone levels, resulting in her producing too many male hormones. 

The hair that grows is typically dark and thick. It can grow in the following places:

  • Back
  • Thighs
  • Buttocks
  • Face
  • Neck 
  • Arms

Hair Loss

Hormonal imbalances caused by PCOS can also result in alopecia or hair loss.

Although women and girls typically produce testosterone, PCOS results in high levels of androgen or male hormones. When women produce an excess amounts of them, it can result in thinning hair. 

Dark Patches of Skin

Teenagers who have PCOS have high levels of insulin in their bloodstream. Elevated insulin levels can sometimes cause dark skin patches. These patches can occur in the following areas:

  • Groin
  • Underarms
  • Back of the neck
  • Face
  • Knees
  • Elbows

The medical name for this skin condition is acanthosis nigricans. The skin patches can look warty or velvety in appearance. 

Check out PCOS and Hormones: Answers to Frequently Asked Questions for additional info.

Why Is It Difficult to Diagnose PCOS in Teens?

PCOS diagnosis in teenagers is problematic because it can't be diagnosed until two to three years after a girl's first period. That's because it can take several years for a girl's period to become regular. 

A PCOS diagnosis is often missed in teenagers because fluctuating hormones are normal for adolescents. Her other symptoms might be overlooked when taking that factor into account. 

If you or your loved one started showing signs of puberty before the age of 10 or experiencing PCOS symptoms, you should speak with your doctor. 

How Doctors Diagnose PCOS in Teenage Patients 

If your doctor believes that you have PCOS, they might refer you to an endocrinologist or a gynecologist. Your healthcare provider will conduct various tests and evaluations to diagnose you with PCOS. 

Your doctor will ask you questions about your menstrual cycle during the initial appointment. You can expect to tell them what the first day of your last period was. They'll also want to know how long your cycles usually are. 

Your doctor will also ask about your family history of PCOS. If your grandmother, mother, or sister has PCOS, you might have an increased chance of having it. 

You can also expect your doctor to conduct a pelvic exam. A pelvic exam can be scary and intimidating if you've never had one, but it's a necessary step in the process.

During the pelvic exam, your doctor will gently check your organs. They'll evaluate the following organs:

  • Uterus
  • Ovaries
  • Fallopian tubes
  • Cervix

To get a PCOS diagnosis, the individual has to have two symptoms present. These symptoms are:

  • Irregular periods
  • Ovarian cysts 
  • Increased testosterone levels

Ultrasound Exam

One of the best ways to diagnose a teenager with PCOS is using ultrasounds. Ultrasound images allow your healthcare provider to see if there are any ovarian cysts present. Two different ultrasounds are commonly used: transabdominal and transvaginal. 

During a transvaginal ultrasound, a tiny probe gets inserted into the vagina. The ultrasound technician carefully guides the probe to capture images of the ovaries and uterus. They'll also measure the size of your ovaries and any cysts that are present. 

An abdominal ultrasound serves the same purpose. The main difference is the ultrasound images are captured by running the device over the surface of your abdomen. 

While a transvaginal ultrasound is more effective at getting clearer pictures of your ovaries, it can be intimidating for younger patients. Speak with your healthcare provider about an abdominal ultrasound if you have concerns. 

Blood Tests for Hormone Levels

Your doctor might order some blood tests to see if your symptoms are caused by PCOS or another condition. You might have gland, thyroid, or ovarian problems.

The blood tests will check your hormone levels. Blood tests are essential for evaluating if you have elevated androgen levels. High testosterone levels are a crucial component of a PCOS diagnosis. 

Find Support if You've Been Diagnosed With PCOS as a Teenager

While there isn't a cure for PCOS, there are several ways to manage your symptoms. Let's discuss some of the most common ones for teenagers. 

Exercise and Diet

Excessive weight gain is a common symptom of PCOS in women of any age. If you're obese or overweight, your doctor might recommend incorporating a healthy diet and exercise routine. Losing weight can also help manage your PCOS symptoms and other related health concerns. 


Your doctor might prescribe birth control pills to regulate your hormone levels. Birth control pills can also result in your periods being more regular. Some girls might experience a reduction in hair growth and acne from taking birth control. 

Birth control pills help by doing the following:

  • Regulating periods
  • Balancing hormones
  • Lowering testosterone levels
  • Decreasing risk of endometrial cancer

Frequently Asked Questions About PCOS in Teens

Doctors and researchers are learning more about PCOS each day. Let's discuss some of the most commonly asked questions about PCOS in adolescents. 

Does My Daughter Have Ovarian Cysts if She Has PCOS?

Some women and girls who have PCOS don't have ovarian cysts. A girl can also have ovarian cysts without having PCOS. That's why it's vital for a girl's hormone levels to get tested to accurately diagnose her with PCOS. 

Why Do I Have Extra Hair or Acne on My Body?

Excess amounts of acne or hair can mean your body produces too much testosterone. All women have testosterone in their bodies. When someone has PCOS, their ovaries make too much of it. 

Your hair follicles and skin cells are very sensitive to when testosterone levels increase. That's why you experience more acne and hair growth if your hormone levels aren't balanced. 

Will My Daughter's Fertility Be Affected By PCOS?

Girls with PCOS have healthy eggs and a functioning uterus. However, many women who have PCOS have trouble with infertility. That's because they don't regularly ovulate due to the higher male hormone levels. 

When your daughter is ready to get pregnant, there are different things she can try to increase her fertility. Staying at a healthy weight and eating well will help improve her fertility down the road. 

Learn More About the Diagnosis of PCOS in Adolescents

It's important to learn more about reproductive health care in teenage girls. Knowing the symptoms of PCOS can help better inform you and your loved ones in working toward a diagnosis of PCOS in adolescents. 

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