January 8, 2018

PCOS in Adolescents – What You Need to Know about Polycystic Ovarian Syndrome

Evelyn M. Artz, MD, of Mission Children’s Specialists in Asheville, offers answers about this fairly common condition in young women.

Q: What is polycystic ovarian syndrome?

Dr. Artz: Polycystic ovarian syndrome (PCOS) is a condition that affects adolescent and adult women. It is a fairly common condition, thought to affect somewhere between 5-10 percent of young women. It is due to a hormonal imbalance that results in elevated circulating levels of androgens. Androgens are the “male” hormones, but both males and females have and need circulating androgen levels. In these young ladies, levels are often times higher than the normal range.

“Poly” means many and “cystic” means cysts, referring to the ovary. However, a young lady does not have to have cysts notable on her ovaries to be diagnosed with PCOS.

Q: What are symptoms of PCOS?

Dr. Artz: Symptoms of PCOS typically occur shortly after puberty and can include:

  • Irregular menstrual cycles
  • Unwanted and increased hair growth (known as hirsutism)
  • Increased acne
  • Metabolic abnormalities, including insulin resistance, which puts these young and adult women at risk for prediabetes or Type 2 diabetes mellitus. There may be darkening patches on the neck and in the underarm area that indicate this underlying insulin resistance (acanthosis nigricans).

Q: How is PCOS diagnosed?

Dr. Artz: There is no one specific test that diagnoses PCOS. A thorough history, clinical exam and blood work help determine hormone values and rule out other possible causes.

Q: How is PCOS treated?

Dr. Artz: Depending on the clinical concerns and labs, PCOS may be treated with several different medications. These include:

  • Hormonal therapy to help regulate periods (for example, an oral contraceptive)
  • A medication, spironolactone, might be added if excessive hair growth is persistent or significant
  • Metformin, a medication that helps with insulin sensitivity and therefore addresses the risk of prediabetes or Type 2 diabetes mellitus
  • Lifestyle changes including weight loss if indicated, healthy eating and increased physical activity

Q: Who should be evaluated for PCOS?

Dr. Artz: Any young lady with:

  • Irregular menstrual cycles that persist 1-2 years after her first menstrual cycle
  • Excessive acne, unwanted excessive hair growth (in particular on face, chin, chest)

While many young ladies with PCOS are overweight, it must be considered in adolescent girls with normal weight with the above concerns.


Evelyn M. Artz, MD, is board certified in general pediatrics and pediatric endocrinology. She currently sees patients at Mission Children’s Specialists in Asheville, NC.

Click here to learn more about pediatric endocrinology services at Mission Children’s Hospital.

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