PCOS often has its origins in adolescence and can be triggered by physiological changes during puberty in genetically predisposed individuals. Early identification and treatment is important to prevent long-term health consequences. Lifestyle modifications including diet and exercise are the primary treatment approach for overweight adolescents with PCOS. Oral contraceptives are also used to treat menstrual irregularities and hirsutism, while metformin may be added to help with hyperinsulinemia and improve ovulation. Counseling adolescents on PCOS aims to help manage symptoms and reduce risks of future infertility or metabolic disorders.

1. narendra malhotra jaideep malhotra neharika malhotra www.malhotrahospitals.com [email_address] .

2. UNDERSTANDING OF PCOS IN VARIOUS AGE GROUPS PCOS WORKSHOPS WERE THE THEME WORKSHOPS OF FOGSI FOR 2010 AND OF ICOG 2011 ALSO A NATIONAL SURVEY WAS DONE BY DR JAIDEEP MALHOTRA AND DR BHARTI DHOREPATIL AND DR MANDAKINI

3. PCOS is not a disease but an ill understood phenomenon defined in various forms over the years

4. PCOS is defined as a heterogeneous disorder Presenting with a constellation of different manifestations throught the life of a women “ THIEF OF WOMENHOOD”

12. CLINICAL MANIFESTATIONS SYMPTOMS ASSOCIATED ENDOCRINE MANIFETATIONS POSSIBLE LATE SEQUALE Obesity(38%) Androgens(29%) Diabetes mellitus(29%) Menstrual disturbance(66%) LH(40%) Cardiovascular disease Hyperandrogenism(48%) LH:FSH ratio Hyperinsulinemia Infertility (73% of anovulatory infertility) Free estradiol Low LDL Asymptomatic(20%) Fasting insulin Endometrial carcinoma Prolactin(27%) hypertension Sex hormone binding globulin

15. Endocrine problems Metabolic problems Infertility Risk of OHSS and multiple pregnancy Pregnancy complications Long term sequel MOST IMP- Importance of life style modification SPECIAL COUNSELING OF A PCOS PATIENT

22. IMPACT OF OBESITY IN REPRODUCTION Condition Associated risks Mensturation Ammenorhoea, oligomennorhoea, mennorhagia Infertility Anovualtion, poor response to infertility drugs Miscarriage Increased rate Infertility treatment Increased requirement of oral or injectable ovulation induction agent Decreased success rate of IVF Glucose intolerance Impaired glucose tolerance, type 2 DM Pregnancy Increased PIH, GDM,CS, Downs

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