PCOS and Teens
With a new diagnosis of PCOS, teens and her parents often have a lot of questions. Often the first question her parent will ask is if she should be taking the birth control pill. PCOS is one of the most common hormonal disorders affecting women of child-bearing age, although we don't know what causes it. It occurs when there is an imbalance of testosterone in the body and can cause acne, infertility, irregular periods and abnormal hair growth or loss. While acne and irregular periods are considered normal in a teenager, if periods start then stop suddenly and other symptoms are present, she should be evaluated for PCOS. Teen girls will often have a few concerns about seeing the gynecologist for the first time.However, early diagnosis and intervention are key in helping a young woman deal with many of the physical changes that accompany PCOS and prevent the depression that can easily occur with it.
PCOS and the Birth Control Pill
One of the most common symptoms of PCOS (teens included) is irregular menstrual periods. During a normal menstrual cycle, the endometrium, or lining of the uterus, is exposed to hormones, like estrogen and progesterone, which cause the lining to proliferate and thicken. Right after ovulation, progesterone levels increase, then drop before menstruation. It is that drop in progesterone levels that triggers the lining of the uterus to be shed each cycle, known as a woman's period. In PCOS, ovulation does not occur regularly, which prevents the rise and fall of progesterone that brings on a woman's period. Instead, the lining is not shed and is exposed to estrogen for a longer period of time causing the uterine lining to grow much thicker then normal. This can cause heavy and erratic bleeding. However, this is not a true period because ovulation has not occurred. Over time, lack of exposure to progesterone may cause endometrial hyperplasia (a fancy word for overgrowth of the uterine lining) which in rare cases can lead to endometrial cancer. Taking the birth control pill regulates your menstrual cycle by providing the progesterone that your body needs, causing the uterine lining to be shed frequently and reducing the risk of endometrial hyperplasia.What Are the Benefits?
Teens experience many of the same symptoms that adult women with PCOS do. They also suffer from many self-esteem issues as they deal with acne, and abnormal hair growth which can lead to depression. Birth control pills will regulate many of the hormonal changes, helping to correct some of the symptoms as well. Having regular periods can also reduce the risk of endometrial cancer.Are There Any Risks?
As with any medication, there can be risks to taking the pill. If you suspect that your daughter may be smoking, or if she has a history of blood clots, the pill may not be appropriate for her to take. Make sure to discuss with her doctor any medications that she is taking, as well as any concerns that you may have. Taking the pill does not increase her risk of developing cancer or blood clots (although clots are rare in a young non-smoker).Are Other Treatment Options Available?
The single most important thing that a young woman can do is lose weight if she is overweight. By following a healthy diet and beginning a regular exercise routine, she can help her body increase it’s response to insulin and possibly decrease androgen production. This may help reduce symptoms, restore normal menses and make it easier to conceive (eventually). However, many normal-weight girls still develop PCOS.
Women with PCOS frequently have insulin resistance, meaning their body does not respond as quickly to insulin. The sluggish response will cause larger and larger amounts of insulin to be required before glucose is taken into the body tissues, and eventually a change in the way the body deals with sugar. Metformin is a medication which is sometimes used in conjunction with the birth control pill which can help the body better manage sugar. Sometimes regulating the insulin and sugar balance will regulate androgen production as well.
Talking to Your Teen About Taking the Pill
It is important that a young girl understand that taking the birth control pill does not protect her against sexually transmitted infections (STI). If she is sexually active, it is necessary that she consider an additional form of birth control which will also protect her from STIs.Smoking can increase the risk of developing a blood clot, so it is very important that she not smoke while taking the pill. Talking to your daughter about these concerns can not only minimize side effects from taking the pills, but can also foster an open relationship with her.
