Weight gain, irregular periods are signs of PCOS

Franky Voss, MD

The Voss Center

Q: My 17 year old daughter has a history of irregular periods ever since they began and now she has stopped having her cycle all together. She has also been gaining weight and has developed some facial hair growth that she finds troublesome. What might be her problem?

A: Although there are many reasons for young women to have irregular menstrual cycles, one of the most common, especially when paired with weight gain and excessive hair growth (called “hirsutism”) is Polycystic Ovarian Syndrome or PCOS.

Q: How would we know if she has PCOS?

A: There is not an exact test that confirms the presence of PCOS. One of the first things that must be done is to rule out the possibility of other causes of amenorrhea (or a lack of periods) before considering the diagnosis of PCOS. Some of the other things that would be checked would include: thyroid dysfunction, pituitary or adrenal gland problems or a testosterone producing ovarian tumor that could also contribute to the hirsutism. Once all of these have been excluded, then PCOS is considered to be the probable diagnosis.

Q: If she does have PCOS, are there any other health risks that we need to be worried about?

A: A fair number of girls who are diagnosed with PCOS also have problems with insulin resistance. This is a condition in which the pancreas (the organ in our body that produces insulin and keeps our blood sugars normal) essentially has to work overtime, producing large amounts of insulin in order to keep the blood sugar normal. These girls do not have diabetes at this time, but have been shown to be at higher risk of developing diabetes and heart disease later in their life.

Q: How is one checked for all of these possible problems?

A: In general, a thorough physical examination and some blood tests are all that is required.

Q: What type of treatment is available for girls with these problems?

A: If a girl has just PCOS without the insulin resistance birth control pills have been shown to be the best method to regulate their periods. If they are having problems with excessive hair growth as well, there are other medications that can be added to slow new hair growth. Unfortunately, these medications will not make the hair that is already present go away. The only means of permanent hair removal would be either electrolysis or laser treatment. If the young woman also has insulin resistance, the focus is altered to treatments that will potentially decrease her risk of serious long-term health risks such as diabetes and heart disease. The first step is promoting a healthy lifestyle which would include dietary changes that are similar to those followed by diabetics, avoiding high calorie/high fat foods. The second step is encouraging regular exercise 3 to 5 times weekly for at least 45 minutes at a time. This helps to improve the metabolism of the sugars and promote weight loss which can sometimes decrease the insulin levels without the need for additional medication. However, when these more conservative methods are unsuccessful, we may have to add an oral hypoglycemic agent (a pill that helps to decrease the blood sugar levels) so that the pancreas doesn’t have to work so hard to keep the sugar levels normal.

Q: Why did my daughter get PCOS and do I have to worry about my other two younger daughters also having this condition?

A: No one knows for certain why some girls get PCOS and others do not. Just because your oldest daughter sounds like she might have this disorder does not mean that the rest of your girls are certain to develop it as well. It does not necessarily “run in the family”. Encourage every member of your family to receive regular yearly check-ups by your family doctor or a gynecologist in order to address any concerns you may have and practice good preventative medicine.

Franky Voss, a physician at the Voss Center is a member of the Ball Memorial Hospital Medical Staff. For more information call (765) 286-3900 or email info@chsmail.org.

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