Diagnosing PCOS in Children

Symptoms That Warrant a Doctor's Visit

doctor and teen girl
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It is not common that a prepubescent female would be diagnosed with polycystic ovary syndrome.In most situations, girls who have not yet had their first menstrual period (also known as menarche), do not experience the symptoms typical of PCOS such as:

  • irregular periods
  • abnormal hair growth
  • elevated androgen levels

However, there are circumstances where a young girl would go through puberty much earlier than normal. This is known as precocious puberty and is usually diagnosed when a child enters puberty before the age of 8 for girls and the age of 9 for boys.

One study published in Fertility and Sterility in January of 2009, looked at the prevalence of PCOS in young women who had undergone precocious puberty. Researchers found that women with precocious puberty are "prone to developing PCOS."

PCOS During Adolescence

A PCOS diagnosis is less common in adolescents since irregular menstrual cycles due to fluctuating hormones can happen for some time. However, it is very much possible for PCOS to become symptomatic during adolescence since at least 5% of reproductive-age women are affected by chronic hyperandrogenism (too many hormones) and oligo-anovulation (infrequent, irregular or absent ovulation).

Some common signs of PCOS include:

  • Irregular periods, or too frequent, close together periods, or the absence of periods
  • Excess hair on your face or other parts of your body, referred to as hirsutism (her-suit-is-em)
  • Acne on the face and body
  • Obesity, weight gain, or trouble losing weight (or all three at once)
  • Patches of dark skin (particularly on the back of your neck), this condition is called acanthosis nigricans.

Research suggests that PCOS may run in families. It may also be related to the production of too much insulin in the body, which signals the ovaries to release extra male hormones (androgens).

When to Take Your Daughter to a Doctor

If a young girl begins experiencing ferocious puberty at a very young age, or an adolescent begins to experience the above PCOS symptoms, she should be evaluated by a physician.

A full hormonal workup should be performed to determine if there is an outside cause. She may not reach diagnostic criteria of PCOS immediately but may be at a greater risk of developing it later in adolescence.

Untreated PCOS can put a girl at risk for other problems in the future since women with PCOS are more likely to have the following problems:

  • Infertility
  • Excessive hair growth and acne
  • Obesity
  • Diabetes
  • Heart disease
  • High blood pressure
  • Abnormal bleeding from the uterus
  • Cancer

What a Doctor Will Want to Know Before Diagnosis 

Your doctor will need to ask a series of questions and conduct some tests before a PCOS diagnosis is deemed appropriate, such as:

  • Details about your child's menstrual cycle
  • General health questions
  • Complete physical examination
  • Blood test to check hormone levels, blood sugar, and lipids (including cholesterol).
  • Ultrasound test. This is a test that uses sound waves to make a picture of your reproductive organs (ovaries and uterus) and bladder (where your urine is stored). In girls with PCOS, the ovaries may be slightly larger (often >10cc in volume) and have multiple tiny cysts.

Diagnosing the condition is an important first step because getting treatment for PCOS reduces the chances of developing other serious problems. The good news is that, although there's no cure for PCOS, it is treatable. Be sure to seek the advice of a medical professional if you suspect that something is not right.

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Article Sources
  • Bremer, Andrew A. “Polycystic Ovary Syndrome in the Pediatric Population.” Metabolic Syndrome and Related Disorders Oct 2010 8:5  375–394. 
  • Franceschi, Roberto et al. "Prevalence of polycystic ovary syndrome in young women who had idiopathic central precocious puberty."Fertility and Sterility, Mar 2010 93:4,1185 - 1191
  • Rosenfield, Robert L. "Identifying Children at Risk for Polycystic Ovary Syndrome" The Journal of Clinical Endocrinology & Metabolism, 2007 92:3, 787-796.