New Delhi: One in five adolescent girls surveyed across schools reported menstrual irregularities, an ongoing AIIMS survey of nearly 4,000 girls has found.Doctors said irregular periods cannot by themselves be taken as a sign of polycystic ovary syndrome (PCOS). The survey is yet to establish how many of the girls have the condition.The survey, conducted across govt and private schools since 2023, is assessing menstrual patterns and other features linked to adolescent PCOS. The condition was renamed polycystic ovary and metabolic syndrome (PMOS) in May 2026 to highlight that its impact extends beyond menstrual problems to a range of metabolic and other health complications.Dr Rajni Sharma, professor, division of paediatric endocrinology at the department of paediatrics in AIIMS, said menstrual irregularity needs to be assessed in the context of the girl’s age and time since menarche, which is the first menstrual period, as well as other clinical features.Some irregularity is normal during the first year after the first period, said Dr Vandana Jain, another professor in the same division of AIIMS.However, persistent abnormalities need evaluation. Cycles less than 21 days or more than 35 days apart, or a gap of over three months between periods, can warrant investigation, depending on the time since menarche.Doctors also cautioned against the opposite problem, which is overdiagnosing PCOS based solely on an ultrasound showing a “polycystic” appearance of the ovaries.Such an appearance can be normal in adolescents and does not by itself establish PCOS. The diagnosis should instead focus on persistent menstrual abnormalities and evidence of androgen excess, such as excessive facial or body hair or severe acne, after ruling out other possible causes. “PCOS is a diagnosis of exclusion,” doctors said.The ongoing survey, therefore, cannot yet provide a PCOS prevalence figure. The 20% figure relates to menstrual irregularity and should not be interpreted as the proportion of girls with PCOS.PCOS can occur in girls of normal weight as well as those who are overweight. A family history of PCOS, obesity or type 2 diabetes can increase risk, while unhealthy diets, highly processed foods, sedentary behaviour, excessive screen time and inadequate physical activity may also contribute.The condition can have consequences beyond menstrual health, including insulin resistance, obesity, dyslipidaemia, diabetes and fatty liver. “Adolescents may also experience anxiety, depression, eating disorders and poor body image, particularly when excessive facial or body hair or weight gain becomes an issue. Some may face teasing or bullying at school,” said Dr Renu Sharma, child psychologist, department of psychiatry.Doctors stressed that early identification should be accompanied by lifestyle measures rather than unnecessary medication. Regular physical activity, minimally processed food, adequate fruits and vegetables and sufficient protein are recommended.They also highlighted the importance of tracking children’s growth, particularly rapid weight gain following low birth weight, which may increase the risk of metabolic problems.As the survey continues, further assessment is expected to establish how many girls actually meet the diagnostic criteria for PCOS.
