‘September PCOS awareness month’ : PCOS in Adolescents
Dr. Sharmin Abbasi : Adolescent is defined as a Transistional Stage of Physical and Psychological Development from Puberty to Adulthood.
According to WHO, young females of age group 10-19 years old are considered as adolescents. PCOS is a metabolic and hormonal disorder found in women. Incidence of adolescents PCOS is nowadays. Adolescent PCOS is a hetreogenous endocrine disorder diagnosed in 5 to 10 % of adolescent girls and one of the major cause of adolescent hyperandrogenism and menstrual irregularity. The pcos is considered to be most prevelant of all endocrine disorder which women face . PCOS can be challenging to diagnose and treat in adolescents. It is often confused with Congenital Adrenal Hyperplasia ,Cushings Syndrome ,Thyroid Dysfunction, Hyperprolactenemia which symptoms are strikingly similar to PCOS including weight gain, Hirsutism,Facial Puffiness and change in skin texture. Over half of the patients with PCOS are over weight or obese, placing them at high risk for obesity related co-morbidities. Because of the significantly associated metabolic abnormalities and the quality of life(QOL)which is an emergency problem in adolescents.
Acne , Premature Adrenarche and Hirsutism that occur before puberty have been associated with PCOS in adolescents. PCOS is influenced by genetic and environmental factors . PCOS seems to run in families too, So, if someone in the family have PCOS ,then others might be more likelyto be develop it .
Proposed adolescent PCOS diagnostic criteria
-Hyper Androgenism(Biochemically Confirmed)
-MensturalIrregularities( present for at least 2 yrs post menarche)
-Polycystic Ovaries( Include increase in size and increased in number of follicles)confirmed by ultrasound and exclusion of other etiologies[congenital adrenal hyperplasia, Thyroid dysfunction, Hyperprolactenemia and cushing syndrome) are to be excluded. Although there are well known criteria for PCOS, newer diagnostic tools under study include anti-mullerian hormone and revised ultrasound criteria. There is said to have no cure for PCOS , but there are several ways to treat and manage the condition. Treatment for PCOS include weight loss for those who are over weight as well as metformin to address insulin resistance and other cardiometaboilc risk factors and other hormonal medications. PCOS is being underevaluated and possibly underdiagnosed in the adolescent population. Now-a-days, support( physical and mental health) by parents plays a great role in treating PCOS . Counselling for adolescent girls should be included in school curriculum which will provide an awareness towards the disorder and life style modification.
The writer is Infertility Specialist & Associate Professor, Anwer khan Modern Medical College Hospital.