Anita Mani
GIFT IVF Center, Cochin, India
Title: Difficulties in diagnosis and management of PCOS in teens
Biography
Biography: Anita Mani
Abstract
The clinical symptoms of PCOS in teenagers often overlap with the normal development, making it difficult to diagnose the condition. The symptoms like irregular periods can be found in normal adolescents, as it takes a few years for hypothalamo-pituatory axis to become mature after menarche. Acne is a sign of hyperandrogenism, but it is found in 80% teenagers and hence not specific for PCOS. Hirsutism is related to the duration of exposure of androgens, and becomes marked towards adulthood. The third criteria as per Rotterdam criteria of polycystic ovaries on scan can be missed on a trans-abdominal scan, especially in obese girls. Teenagers can have multi cystic ovaries without PCOS. The intake of contraceptive pills can mask the symptoms. General reluctance towards a consultation at that age can often delay the diagnosis; especially as they are prone to social isolation, anxiety and depression in addition to mood variations and irritability. Weight loss is well known as the most difficult target due the hormonal abnormalities. Motivating obese girls to lose weight takes professional help, targeted behavioral change techniques, which is not widely practiced. Dietary changes and regularity of food intake are difficult to impose on young girls. The most important aspect is counseling, and is very much lacking in the current management. Risks of metabolic sequelae are often overlooked.