PCOS in Teenagers…The Upcoming Epidemic

One in five Indian females suffer from PCOS. The incidence is on the rise. Why?? This may be related to genetic tendency, more sedentary lifestyle, more screen time, changing dietary preferences.

This is a condition which has symptoms varying from irregular periods, pimples, excess hair growth on body and hairfall. There may be problems with conceiving and pregnancy related complications like high blood sugars, miscarriages and high blood pressure. If the condition is not well managed, these girls stand at a risk of high blood pressure, diabetes, heart attack and even cancers in later life.

Due to long term issues associated with the condition, it is imperative to diagnose and manage it well in young girls. For young girls, the diagnosis is by a combination of irregular periods and symptoms of hyperandrogenism (like acne, hairfall, obesity, excess facial and body hair). ULTRASOUND IS NOT RECOMMENDED FOR DIAGNOSIS OF PCOS IN YOUNG GIRLS TILL THE AGE OF 8 YEARS AFTER THE START OF PERIODS. Subjecting them to repeated ultrasounds may add to the anxiety of very tender and anxious girls of this age group.

In young girls, in first year after the start of periods(menarche) cycle length of upto 90 days is considered normal. Gradually by three years after menarche this may reduce to 45 days and after that we expect the cycles to become regular. So, this should be included in the counselling so as to reduce the anxiety of mothers and the girls.

The management of this condition needs a holistic approach including lifestyle measures and medical treatment. Encouraging a healthy and active lifestyle in our young girls is the need of the hour. Any physical activity of their choice be it dance, walk, swimming, for atleast 30 minutes a day for atleast 5 days a week starts showing results. Even 5-10% of weight loss helps in reduction of symptoms and regularization of periods.

Diet rich in proteins, fibre like broccoli, cauliflower, nuts, seeds, beans, tomatoes, fresh fruits and vegetables, less processed foods like maida should be encouraged. We should involve the mothers as well as the teenager herself in this effort and encourage five small meals instead of three big meals. Some girls may require medications and cosmetic treatments also for their symptoms. These treatments are largely safe and keep the condition under check.

Some girls with PCOS may have body image issues due to obesity, hair growth and other related issues. We need be sensitive enough with such girls and help in boosting their self  esteem.

I tell my patients that though PCOS does not have a cure but together we can manage this condition with lifestyle measures and medications and offer a healthy and beautiful future for our teenage girls.

Our Expert

 

Dr. Shifali Sood is working as consultant in the department of Obs. & Gynae. at SPS Hospital, Ludhiana. She had done her M.B.B.S. from Baba Farid University of Health Sciences, Government Medical College, Patiala and M.S. (Obstetrics and Gynecology) from Himachal Pradesh University, Dr. Rajendra Prasad Government Medical College, Tanda at Kangra, HP. She also done Diploma course in IVF ICSI and Infertility Management certified by Delhi Gynecologist Forum, July 2020 as well as Diploma course in Basic Obstetric and Gynecology (Ultrasound) certified by Delhi Gynecologist Forum September 2020. She has also cleared MRCOG exam by RCOG, London in April 2022.

Dr. Shefali Sood