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Irregular Periods, Acne and Facial Hair: Is it Polycystic Ovarian Syndrome?

Jul 02, 2020
Teenager girl looking in the mirror touching her face

What Is Polycystic Ovary Syndrome?

Polycystic ovarian syndrome – or “PCOS” – is a hormonal imbalance that happens in some girls and women. In PCOS, testosterone, a type of hormone, is higher than normal. All women make some amount of testosterone, but in women with PCOS the testosterone levels are higher than normal.

In healthy females, the ovaries release an egg about once a month. In young women with PCOS, high testosterone levels get in the way of regularly releasing an egg from the ovary. This leads to a change in periods. High testosterone levels can also lead to the development of acne and excess body hair.

We are not exactly sure what causes PCOS – it may by partly due to genetics, but there are likely many causes.

How Common Is This Condition? Who Is Affected?

Between 5%-10% of women of having periods have PCOS. Women of all races and ethnicities are at risk of PCOS.

What Are the Signs and Symptoms of PCOS?

  • Irregular menstrual cycles: no periods, infrequent periods, or too much uterine bleeding
  • Acne
  • Too much hair on the face, chin, or parts of the body where men typically have hair
  • Obesity
  • Darkening of the skin along neck creases, groin, or underneath breasts

How Is PCOS Diagnosed?

Adolescent girls with abnormal periods, acne or excess hair growth should be seen by a health care provider who will ask questions and perform a physical exam. Often the health care provider will order labs (blood work) to check hormone levels. Sometimes an ultrasound is performed to evaluate the patient’s ovaries.

It’s important to remember that some irregular periods and acne may be normal in adolescents. Your health care provider will discuss which patterns are normal, and which are not.

How Is PCOS Treated?

The goal of treatment is to manage periods and protect the uterus, to reduce the unwanted symptoms (acne, excess hair growth) and to lower the risk for other health problems.

Healthy weight – Women with PCOS should eat small, healthy, balanced meals and aim for at least 30 minutes of physical activity every day; this will help with excess weight and can lower the high levels of insulin and testosterone. Sometimes, healthy nutrition and exercise is all that is needed to help regulate hormone levels. Sometimes, a medication may be prescribed to help with blood sugar.

Menstrual management – To prevent the uterine lining from becoming too thick and to prevent irregular menstrual bleeding, birth control pills may be used to help shed the uterine lining on a regular basis or to help prevent the lining from becoming too thick. The pill can also help lower testosterone levels and reduce the amount of acne.

Excess hair Shaving, waxing, hair removal creams and laser hair removal can all help get rid of unwanted hair growth from the skin. There are also medications available to help lower testosterone levels and, therefore, reduce excess hair

What Complications Arise From Waiting Too Long for Treatment?

If PCOS is not treated, women may be at a higher risk of:

  • Type 2 diabetes
  • Obstructive sleep apnea
  • Abnormal bleeding from the uterus
  • Depression
  • Difficulty getting pregnant (even though some patients with PCOS may take longer or need help to become pregnant, women should always use birth control that prevents sexually transmitted infections and if they are having sex and don’t want to become pregnant)
  • High blood pressure and high cholesterol
  • Heart disease

What Is the Long-Term Outlook for Those Affected by Polycystic Ovary Syndrome?

With weight loss and a healthy diet many women can reduce long term risks associated with PCOS. Once women are on treatment – the symptoms of PCOS are usually well-controlled.

Pediatric and Adolescent Gynecology at Nationwide Children's
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Kate McCracken
Katherine McCracken, MD
Pediatric and Adolescent Gynecology

Kate McCracken, MD is a distinguished member of Nationwide Children’s Pediatric and Adolescent Gynecology team.

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