Young Girls and PCOS

A family turned to their pediatrician for help when their 16-year-old daughter wasn’t able to control her excessive weight gain, acne problem or abnormal hair growth.

After referral to a gynecologist, it was discovered the girl’s insulin levels were elevated. Oral contraceptive pills were prescribed to regulate her menstrual cycle, and she was put on a diet and exercise program. Within nine months, the teen-ager lost 45 pounds, most of her facial hair was gone and her acne had cleared.

The case is not unusual, says Dr. Karen Bradshaw, director of pediatric and adolescent gynecology at Children’s Medical Center of Dallas. The department is treating an increasing number of adolescent girls who have polycystic ovary syndrome (PCO). Typically, girls with PCO have developed cysts on their ovaries and have an increase of male hormones in the body. Many of these girls also develop a diabetes-like insulin resistance.

The metabolic disorder has symptoms that include irregular menstrual cycles, abnormal hair growth – such as sideburns or mustaches – acne and excessive weight gain. If left untreated, as many as 40 percent of the girls can develop diabetes. The cause of the syndrome is not clear, although a combination of genetics and obesity is thought to trigger the disorder, Dr. Bradshaw says.

“It’s really devastating, socially,” she says. “A lot of the girls don’t understand healthy eating patterns and lifestyle issues. And it can require a lifelong adherence to diet, exercise and medications.”

Dr. Bradshaw says PCO is becoming more recognized because there is a better understanding about the relationship between androgen excess and obesity.

“We’re able to diagnose it in younger girls, and with some lifestyle changes, we can help reduce the symptoms,” she says.

Dr. Rebecca Lavy, a physician in the gynecology clinic at Children’s Medical Center, says treatment of the disorder can include one or more of the following: birth control pills, weight reduction, increased exercise and medications to increase insulin sensitivity.