Polycystic Ovarian Syndrome (PCOS) is one of the most common hormonal disorders affecting adolescent girls and women, often emerging during the teenage years. PCOS is a hormonal imbalance that affects the ovaries, leading to an overproduction of androgens, also known as “male hormones,” which can disrupt the normal development and release of eggs during the menstrual cycle.
Adolescence is a time of hormonal changes, and it can sometimes be challenging to distinguish between normal puberty and the signs of PCOS. This hormonal imbalance presents a wide variety of symptoms, and not every individual will experience all of them.
Symptoms of PCOS include irregular menstrual cycles, acne, and an increased amount of hair growth on the face and body—a condition known as hirsutism. Some girls with PCOS experience thinning hair on the scalp, weight gain, or even male-pattern baldness. Additionally, some girls with PCOS struggle with anxiety and depression due to the physical and emotional impacts of the disorder.
PCOS is typically suspected during an adolescent’s visit to their pediatrician and then diagnosed by a pediatric endocrinologist or gynecologist. Diagnosis involves a review of the patient’s medical history, followed by a physical exam. Blood tests are often conducted to check hormone levels to rule out other conditions with similar symptoms. Pelvic ultrasounds are generally not recommended in adolescent girls unless the testosterone level is at least 200 (to make sure there is no hormone-producing mass), if there is pelvic pain concerning for an ovarian cyst, or if there is a concern for obstruction to menstrual blood flow. This is because ovarian cysts are not necessary for diagnosing PCOS, and pelvic ultrasounds can be confusing to interpret while the menstrual cycles are developing.
One of the first approaches to managing PCOS symptoms is hormonal birth control, which can help regulate periods, reduce acne, and decrease excessive hair growth by lowering androgen levels. For girls who may not want to take birth control or sometimes in addition, other medications such as anti-androgens can help manage symptoms like hirsutism. Metformin is sometimes used if there is evidence of insulin resistance and risk for Type 2 diabetes, as lowering insulin resistance can also decrease androgen levels.
Lifestyle changes also play a crucial role in managing PCOS. A healthy diet, regular exercise, and maintaining a healthy weight can improve hormone levels, regulate menstrual cycles, and reduce symptoms such as acne and excessive hair growth. Early intervention and proper care are key to minimizing the potential long-term effects of PCOS, such as infertility, diabetes, and endometrial cancer.
The Miller Children’s Torrance Outpatient Specialty Center—a satellite center of Miller Children’s & Women’s Hospital—provides pediatric specialists close to home, including those trained to evaluate and diagnose PCOS and other hormonal disorders. Should the need arise, the center serves as a bridge to more advanced care just down the road at the Endocrine Center at Miller Children’s & Women’s Hospital main campus in Long Beach.
If you suspect your child may have PCOS, it’s important to seek consultation with a pediatric specialist. Early diagnosis and treatment can improve your child’s quality of life and help manage symptoms more effectively.
About Dr. Rebecca Hicks:
Rebecca Hicks, M.D., is an attending pediatric endocrinologist and the medical director at the Miller Children’s & Women's Hospital Endocrine and Diabetes Center. She was a Regent’s Scholar at the University of California, Los Angeles, where she graduated with a B.S. in Biochemistry and a Minor in English.
After working as a validation engineer at a pharmaceutical company for two years, she earned her degree in medicine from the University of Southern California, where she was selected for membership in the Alpha Omega Alpha honor society. She then completed her residency training and chief residency at the Department of Pediatrics at the University of California, Irvine, followed by a fellowship in Pediatric Endocrinology at Harbor-UCLA Medical Center in Torrance, California. In addition, she was selected to participate in a two-week preceptorship at the National Institutes of Health, which was sponsored by the Endocrine Fellows Foundation.
Dr. Hicks is board-certified in pediatrics and pediatric endocrinology. She sees every interaction with children and parents as an opportunity to make a positive, lasting impact in their lives.