Polycystic Ovary Syndrome (PCOS) in Adolescence

In our society today, when a child is born, he begins to experience certain diseases that can be devastating for development. Doctors have established a routine schedule of growth and development that needs to be assessed, and encourage parents to immunize children against diseases. Prevention is a sound word that has been used repeatedly in hospitals and hospitals, but when applied to polycystic ovarian syndrome (PCOS), testing and evaluation are not performed until the age of majority, when the condition is out of control, and complications have already begun. Testing and evaluating PCOS in adolescence should be used to prevent PCOS from destructive complications.

Do women know that they have, can be treated, and if not treated, it can lead to devastating disease? There are many women who suffer from daily complications associated with untreated PCOS. For many women, testing is not performed. Because, in fact, PCOS women do not even know that there is something that can be done for the symptoms and continue to suffer. According to the American Association of Clinical Endocrinologist (AACE):

PCOS is the most common metabolic disorder of women of reproductive age in the United States, which is commonly known as a reproductive disorder, but is also associated with life-threatening medical illnesses. In the US, this syndrome suffers from six million women of reproductive age. ("News bulletin")

PCOS was discovered before computers were invented and [2005] There is still no assessment for PCOS in adolescence when symptoms begin to develop. Symptoms associated with PCOS were first reported by Irving Stein and Michael Leventhal in 1935 (9). Women with menstrual problems who have had large ovaries due to multiple cysts [classical symptoms] Stein-Leventhal syndrome was diagnosed. Due to more research, these symptoms became only a subset of the more comprehensive syndrome called PCOS. Many people in the medical profession simply call it PCO, because the symptoms will vary in people.

Statistics show that not a single person has the same symptoms, but physicians should be able to make reasonable guesses and send women in the form of testing much earlier than into adulthood (11). By the time complications caused by lack of treatment are treated with some women, some women become infertile, overweight and depressed. In Living with PCOS, Angela Boss declares:

Although the age of onset of PCOS symptoms varies, most women with PCOS may recall their teenage years and recall the point in time when they began to feel “different” and wondered if something was wrong with them. (1)

Signs and symptoms of PCOS include irregular menstruation, absence of menstruation, rare menstruation, central obesity, growth of excess body hair, acne, ovarian cysts, and infertility (2). Abnormal test results, such as elevated levels of male hormones, lower female hormones, impaired insulin, and a decrease in the level of sex hormone (8).

Another abnormal PCOS test that should be evaluated as part of a routine screening for a teenager is the cholesterol test. In the process of evaluating cholesterol (4) a new test is used. VAP (vertical automatic profile) helps to assess cholesterol levels and, apparently, certain factors of cholesterol increase only in women with PCOS (12). As additional studies are being conducted to confirm this information, this may be the ultimate test for patients with PCOS (4). Most parents were very worried when it came to medicines, and some proof was needed that there was something wrong before starting treatment. Without a VAP test, many parents cannot take the word of the doctor, only on the basis of the symptoms, your child has PCOS, and he will need to take medicine for treatment. The drug will be used to treat PCOS and insulin resistance (IR).

IR over insulin production is one of the most severe, but treatable syndrome associated with PCOS (10). Acanthosis Nigricans (velvety thickened hyperpigmentation of the skin, brown spots) may be present at the nape of the neck, armpits, beneth area of ​​the chest and open areas (elbows, joints) a sign of insulin resistance (2). However, it is also one of the symptoms used by a doctor to diagnose PCOS. Studies have been conducted to determine if the IR process causes PCOS or PCOS causes IR. A dispute is like the question of what happened first with a chicken or an egg. “Insulin resistance, if not treated, can lead to glucose intolerance or type 2 diabetes mellitus” (2). Treatment should be started as soon as possible to avoid complications. To start treatment, it is necessary to diagnose the condition.

A diagnosis of PCOS is a difficult thing that can be obtained from many doctors. The reason mentioned above is that the symptoms vary from person to person, and many doctors still follow the classic symptoms and do not know how to treat this syndrome. Mayoclinic says: “Managing PCOS with special attention to every woman: infertility, hirsutism, acne or obesity,” as most doctors today consider this syndrome. My daughter, Aliza, experienced this first hand, when she could not lose weight no matter what she ate, or how much she trained. Although the doctor told Alize in one doctor's office that she needed to study more, eat less, see someone for her depression. Aliza was very depressed and did not feel self-esteem due to being overweight. She believed that the recommendation of the doctor was not the answer and began to engage in research. Fortunately, she found a doctor who knows about the PCOS and how to treat it. As my daughter experienced most PCOS, it was made to suffer and think that the symptoms were in their head, or it was exactly how they were made, and they would have to live with the symptoms.

As more and more research has been done, there is a wealth of information available to the medical community and women. AACE, in conjunction with the Polycystic Ovarian Syndrome Association (PCOSA), is trying to train doctors and women of all ages in an information campaign (2). Most sites on the Internet have a conference schedule and public forums for educating people about PCOS. Associated Press picked up PCOS and reported: Doctors often cannot connect scattered symptoms. There are also stories about how PCOS affects women, such as “Hidden fertility disorders can lead to diabetes” (7). For the purpose of training medical professionals, AACE introduced this Regulation:
The doctor should no longer treat these women as simple irritating cosmetic complaints or, first of all, infertility, but as potential metabolic disorders that may be associated with type 2 diabetes and cardiovascular events. (2)

Training of doctors and women is necessary for early diagnosis. Before someone can be treated for an illness, they need to know that there is a cure available to them. With education that started on AACE, there is a higher chance of getting PCOS in adolescence.

Dr. Fowley, a pediatrician who specializes in the problems of adolescent gynecology, said in our interview: "Adolescence with abnormal periods should be evaluated for PCOS." When asked why this assessment is important, Dr. Fowley had several reasons. Early treatment of PCOS in the future will prevent complications. The incidence of adult diabetes in young and younger children has increased. Weight gain puts them at risk for diabetes and heart disease. It also has a great influence on self-esteem, which is extremely important for a developing child. We also know that PCOS affects the neurotransmitters of the brain and can cause depression.

The final reason for the treatment of PCOS in adolescence was a completely unique philosophy. Before our interview, I did not even think about the consequences. According to Dr. Fowley, a teenager with PCOS has a higher testosterone level. This high testosterone level makes women feel more manly. Another symptom that most will have is the absence of periods or very irregular periods. That, combined with a high level of testosterone, can make a girl feel not very feminine. “Insulin resistance (IR) almost always goes hand in hand with PCOS, and girls who have IR will have problems with weight gain and difficulty with weight loss” (10). Put it all together, and Dr. Foley feels that it can lead girls to bow down and alternate the lifestyle of homosexuality:

Girls come and make statements such as “I don't feel good” and “I don't look like other girls, and“ I don't feel like a girl. “This is partly due to the fact that hormone levels are not in the normal range. It is associated with PCOS and IR. After the treatment of PCOS, the girls returned to the statement that now they feel much more like a normal girl, because now they have periods and their testosterone levels are within the normal range.
Studies have confirmed the precedent of PCOS in adolescence. In the study of Dr. Mahin Hashemipur, he concluded that PCOS is a common endocrine disorder in adolescents. Adolescents with a mother or sister who have PCOS and PCOS symptoms should be evaluated for this syndrome to prevent its potential complications (6).

The treatment of PCOS varies from one doctor to another. A new philosophy is to focus on the root cause of PCOS. “Many of these new treatments are designed to lower insulin levels and, thus, reduce testosterone production” (3). Dr. Foley agrees with this new approach, but she believes that emphasis should be placed on the nutritional side of the treatment. Drug treatment aimed at reducing insulin levels and changing eating habits has shown that most PCOS and IR symptoms are eliminated.

The role of hereditary factors in the development of PCOS, metabolic abnormalities associated with it, and the use of insulin-sensitive agents in the treatment of PCOS is currently being conducted at the University of Chicago by Dr. David Herman and his team. Metformin is an insulin-lowering drug. It has been approved by the FDA for the treatment of diabetes, but not yet approved by the FDA for use in the treatment of PCOS. These studies will help determine whether metformin helps reduce insulin production in a PCOS patient. Dr. Gluck’s research found:

In adolescence and childbearing, before the advent of metformin therapy, the treatment of PCOS was directed (albeit with little success) to clinical characteristics. Metformin, a safe and effective widespread oral medication, increases insulin efficacy at the level of peripheral cells, reduces hyperinsulinemia and reduces hyperandrogenism, in turn, thereby correcting this biochemical domino effect, correcting it at the source.

Dr. Foley is currently using metformin for the treatment of PCOS, and has found dramatic results in his patients and the patients of her husband, Dr. Stephen Foley, certified by a gynecologist. Dr. Fowley and her husband treat patients with a combination of metformin and nutritional therapy. After the diagnosis of PCOS, the patient should see a nutritionist at the time of appointment. During the assessment of my daughter, the nutritionist explained that a diet that limits carbohydrate to 30-50 grams per day, and an increase in protein to 80-100 grams per day, will help reduce insulin levels. As Dr. Fowley said: "This is a change in lifestyle that will be with you for the rest of your life." If the diagnosis of PCOS was made during the teenage years, this change in lifestyle could begin earlier and help significantly reduce the risk of long-term complications much earlier. Younger women would be easier to adapt to this new way of life than when they are much older and set themselves a path.

Most women report one or more symptoms to their doctor, but if the doctor is not trained to recognize the symptoms and does not associate them with each other, many women will suffer until their symptoms worsen or they have more symptoms. “Irregular or difficult periods can signal a condition in adolescence, or PCOS may occur later when a woman has difficulty with pregnancy” (8).

Currently there is no screening, which is done until a woman sees a doctor to treat her symptoms. If early diagnosis and treatment of PCOS can help reduce the risk of long-term complications in six million women, then why is there no screening in adolescence? Testing and evaluating PCOS in adolescence should be used to prevent PCOS from destructive complications.

Produced work

1. Boss, Angela, Evelina Weidman Sterling and Richard Legros. "Teenage females." Life with PCOS. Omaha: Addicus, 2001.

2. Cobin, Rhonda, et al. "Statement by the American Association of Clinical Endocrinologist on the metabolic and cardiovascular effects of polycystic ovary syndrome." American Association of Clinical Endocrinologists. October 2004 April 10, 2005 [http://www.aace.com/pub/pcos2004/index.php]

3. Ehrmann, David et al. "Treatment Options." University of Chicago Polycystic Ovary Syndrome Center. April 10, 2005
http://centerforpcos.bsd.uchicago.edu/Treatment_options/treatment_options.html.

4. Foley, Deborah. Pediatrician Advanced Gynecology Prof. LLC. Personal interview. March 15, 2005, 719-633-8773.

5. Glueck, CJ "Metformin: the treatment of choice in polycystic ovary syndrome." Health Alliance on the line. Scientific update September 5, 2000 April 7, 2005

6. Hashemipour, Mahin, et al. "The prevalence of polycystic ovary syndrome in girls aged 14-18 in Isfahan, Iran." Hormone Research: 2004, Vol. 62 Issue 6, p278, 5p. Article. EBSCOhost. End of college front, Westminster Leeb. February 10, 2005 http://rpa.westminster.lib.co.us/rpa/webauth.exe.

7. "Latent fertility disorders can lead to diabetes." Associated Press. October 11, 2004. February 11, 2005 http://msnbc.msn.com/id/6227116.

8. Hunter, Melissa and James Sterret. "Synthesis of polycystic ovaries: it is not just sterility." American Academy of Family Physicians 62 (2000): 1079-88. March 22, 2005 http://www.aafp.org/afp/20000901/1079.html

9. Marrinan, Greg. "Polycystic Ovary Disease (Stein-Leventhal Syndrome)". Emedicine. August 30, 2002. February 22, 2005 http://www.emedicine.com/radio/topic565.htm

10. Choose Marcel. "Insulin resistance in women." Women for women on the line. April 9, 2005 [http://www.womentowomen.com/LIBinsulinresistance.asp]

11. "Polycystic ovary syndrome". Mayo Foundation for Medical Education and Research. November 14, 2003 February 2, 2005 http://www.mayoclinic.com/invoke.cfm?id=DS00423

12. "VAP Test: A New Standard for Assisting Cholesterol Risk Assessment." Medco Forum. 8 (2001): 36. April 29, 2005
http://www.atherotech.com/information/default.asp?section=aa&location=1