Importance of early diagnosis and lifestyle management of PCOS in adolescent girls

In a cross-sectional study of 86 adolescents (13-19 years) from paediatric and women’s outpatient hospital clinics in South Australia 1, results showed that 66% of patients saw 1-2 health professionals before diagnosis was made. While 57% of the adolescents were happy with the diagnosis they were dissatisfied that information was not provided after diagnosis in relation to lifestyle management, long-term complications and emotional support and counselling. 

The study concluded that the majority of adolescent girls with PCOS did receive a timely diagnosis but delayed diagnosis still occurred in a minority of adolescents. While the study was a small sample size, it indicates that more needs to be done to meet the needs of adolescents and there appears to be a lost opportunity for preventive healthcare at a critical transition to adult care. 


What is PCOS?

PCOS is a common endocrine condition affecting 8%–13% of women in the reproductive age, and 3%–11% of adolescent girls (depending on the diagnostic criteria used and population studied). PCOS symptoms include irregular menstrual cycles, clinical signs of hyperandrogenism (hirsutism and/or acne) and/or hyperandrogenemia. 

In addition to these symptoms, women with PCOS are at a greater risk of weight gain and excess weight, gestational diabetes, type 2 diabetes, infertility, symptoms of depression and anxiety and impaired quality of life.

Doctors can use an International evidence-based guideline for PCOS diagnosis during adolescence to avoid under or over diagnosis.  The guideline recommends that the diagnosis of PCOS in an adolescent girl should be made based on the presence of irregular menstrual cycles, well-defined from the onset of menstruation, and clinical and/or biochemical evidence of hyperandrogenism.  Ultrasound can be used to confirm diagnosis in adults but is not required in adolescence as it can lead to over diagnosis.

What should I eat if I have PCOS?

PCOS diets should aim for high fibre, low glycemic ingredients and hormone-balancing nutrients.

The diet should consider the common concerns of women struggling with Polycystic Ovarian Syndrome including excess body weight, insulin resistance, acne, and high blood pressure.

To combat insulin-resistance, you should choose foods with a low glycemic load.  Always pair carbohydrates with fat and protein and eat every 2-3 hours to ensure stable blood sugar levels. Include ingredients that are high in hormone-balancing nutrients like indole-3-carbinol and calcium-d-glucarate.

Eat lots of cruciferous vegetables and lean proteins, along with anti-inflammatory chia seeds and turmeric. Grain free is the best option so that carbohydrates are derived from only the most nutrient-dense sources.


Low Glycemic Index Foods

Eating the proper amount and type of carbohydrate is important to help balance insulin levels. A gluten-free, dairy-free meal plan should use low glycemic foods to optimize blood sugars, hormone levels, and weight management. Carbohydrate sources are paired with fats and protein to create a steady release of energy throughout the day.

High Fibre

Getting enough dietary fibre may reduce insulin resistance and hyperandrogenemia in women with PCOS. Following a high-fibre, sugar-free, grain-free plan can also help to improve hormone abnormalities associated with PCOS. Aim for up to 35 grams of fibre daily from vegetables, quinoa, hummus, nuts, and seeds.

Healthy Fats & Protein

Omega-3 fatty acids provide beneficial effects on PCOS, including hormonal balance, anti-obesity, and anti-inflammatory effects. In combination with a low glycemic diet, getting enough daily protein may help provide endocrine and metabolic benefits. Include omega-3 fats from salmon, walnuts, and chia seeds and up to 25% of daily calories from protein.

Anti-Inflammatory Foods

A PCOS meal plan should contain polyphenols and antioxidants to lower chronic inflammation. You can find polyphenols in cloves, apples, walnuts, spinach, and kale. The polyphenol curcumin in turmeric is incorporated as it is a powerful anti-inflammatory agent. Essential fat-soluble antioxidants like vitamin A and vitamin E reduce oxidative stress. Vitamin A sources include sweet potato, carrots, and salmon, and also olive oil, nuts, and seeds.

Liver Support

The liver is a key organ for regulating hormone balance, chemical levels in the blood, glucose and protein balance, making immune factors, and breaking down and excreting harmful substances. Indoles, including indole-3-Carbinol, is essential to liver support and can be found in cruciferous vegetables like broccoli, cabbage, cauliflower, and kale.


Alexia S. Peña et al, 2022,  Diagnosis Experiences of Adolescents With Polycystic Ovary Syndrome, Clin Endocrinol.  96(1):62-69.