Hormonal problems in adolescent girls

Adolescence, or teenage years, is a phase in life when the body undergoes many hormonal changes, both for boys and girls. It can be challenging for girls as this phase is associated with significant physical and psychological impacts. 

There are several “physiological” changes which can, at times, be confused with hormonal abnormalities. It is common for girls during an initial couple of years (1-3 years) after menarche (beginning of menstrual cycles) to have irregular periods but gradually settle down into a regular pattern.

If the periods are not falling into a regular, predictable pattern after an initial couple of years and they have other issues like significant acne, excessive facial hair, and dark pigmentation around the neck, these are the changes which we should be watchful about and get the evaluation done by a doctor. 

Now with increasing issues with lifestyle-associated problems, we are seeing a significantly high percentage of girls having issues with PCOS or polycystic ovarian syndrome. It has a genetic predisposition, aka genetic tendency, but lifestyle also plays an important role. It is not seen only in girls who have issues with being overweight or obese! Even girls who otherwise look “lean” and “thin” can have issues with PCOS.

Girls have a combination of estrogen, progesterone and testosterone hormones. When the balance is disturbed for any reason, and they have excess male pattern hormones, problems arise. In girls, ovaries and adipose tissue (fat tissue) are the one’s response to testosterone (male pattern hormone) production. Excess fat in the body contributes greatly to this. Therefore, working on decreasing the fat percentage in the body and improving muscle mass helps in the long term in reversing this problem. 

Long-term implications of PCOS?

Girls/women can have issues with irregular periods, acne, and facial hair. Long-term implications can be problems with infertility, Diabetes, and endometrial hyperplasia (thickening of the lining of the uterus), and it also increases the risk of serious conditions like uterine cancer. 

Diagnosis/Evaluation of PCOS

PCOS is diagnosed on the basis is clinical evaluation, certain blood tests and ultrasound. There is not ONE particular test for its diagnosis. 

Management of PCOS

PCOS is a common condition, but it must be managed early in life. First and foremost, correct diagnosis and evaluation of the cause of PCOS are important. Lifestyle modification with a healthy diet and exercise (with particular attention to strength training) is very important for PCOS treatment. Often, girls/women need help in the form of medications (hormonal pills) which can help a lot in managing this condition well in the long term, along with diet and exercise.

These pills are very well tolerated, and one should not hesitate to start these if recommended by your doctor. PCOS treatment also depends on the symptoms one has. A lot of times, multidisciplinary management with the help of an endocrinologist/gynaecologist; dermatologist is needed to help improve over the long term. There isn’t a quick fix for this problem, but small steps in the right direction regularly are what help the most! So PATIENCE, PERSISTENCE AND PERSEVERANCE is the key!!

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