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Polycystic Ovary Syndrome (Pediatric)

What is polycystic ovary syndrome?

Polycystic Ovary Syndrome (PCOS) is a common condition in adolescent girls that appears to be caused by hormone imbalance. The ovaries normally produce the hormones estrogen, progesterone, and androgens. that work in harmony to regulate a girl's menstrual cycle.

In PCOS, the ovaries have increased production of androgens, which impedes both egg development and egg release. Instead of producing mature eggs, the body makes cysts (small sacs filled with liquid). These cysts can build up in the ovaries causing them to become enlarged.

Girls who have a history of premature adrenarche (early development of pubic  and armpit hair) may be more likely to develop PCOS later on.

What are the symptoms of polycystic ovary syndrome?

Signs and symptoms of this condition may include:

  • Irregular periods, or no menstruation
  • Excessive hair on the face, chest, abdomen, or back
  • Thinning hair on the head (alopecia)
  • Acne
  • Darker, thicker skin around the neck, armpits, or breasts (acanthosis nigricans)

Weight gain generally increases the symptoms of PCOS.

How is polycystic ovary syndrome diagnosed?

PCOS is difficult to diagnose in adolescent girls. It requires blood testing, the keeping of a menstrual calendar, and an ultrasound of the ovaries and uterus.

Our Child Health experts also look for any underlying medical conditions such as excessive prolactin production, excessive exercise and dieting, and Cushing’s disease.

PCOS is also associated with several other conditions, including insulin resistance and type 2 diabetes mellitus, elevated triglycerides, non-alcoholic fatty liver disease (NAFLD) and obstructive sleep apnea. If these conditions are suspected additional testing may be required. Further evaluation may include oral glucose tolerance test, imaging of the liver, or a sleep study.

How is polycystic ovary syndrome treated?

We have several medications to treat the symptoms of PCOS, but they do not cure the disorder.

The oral contraceptive pill regulates the menstrual cycle, decreases excess face and body hair (hirsutism) and alleviates acne. The drug, Spironolactone may be added to further control hirsutism and acne. Metformin can be helpful for adolescents with insulin resistance.