Many girls in Nigeria are living with a condition they have never heard of — one that explains their unpredictable periods, stubborn acne, unexpected weight gain, and exhaustion that no amount of sleep seems to fix. That condition is Polycystic Ovary Syndrome, commonly known as PCOS.
At the Endocrine Health Foundation, we see the effects of undiagnosed PCOS every week — in schools, in community clinics, and in the stories girls share at Girls Nest Club meetings. This article is our attempt to put the information where it belongs: directly in the hands of girls, mothers, fathers, and caregivers who need it most.
What Is PCOS?
PCOS is a hormonal disorder that affects the ovaries — the two small organs in a woman’s body responsible for producing eggs and releasing the hormones oestrogen and progesterone. In a girl or woman with PCOS, the hormonal balance is disrupted, causing the ovaries to produce higher-than-normal levels of androgens (sometimes called “male hormones,” though all women naturally produce small amounts).
This hormonal imbalance interferes with the normal release of eggs during the menstrual cycle. Instead of being released, some eggs develop into small fluid-filled sacs called cysts — hence the name polycystic (meaning “many cysts”) ovary syndrome.
PCOS is one of the most common endocrine disorders among women of reproductive age worldwide. Research estimates suggest it affects between 8 and 13 percent of women globally — meaning in a classroom of 30 girls, two or three may have PCOS without knowing it.
What Causes PCOS?
The exact cause of PCOS is not fully understood, but research points to a combination of factors:
Insulin resistance is found in up to 70% of women with PCOS. When the body’s cells do not respond properly to insulin, the pancreas produces more of it. High insulin levels then trigger the ovaries to produce more androgens, disrupting ovulation.
Genetics play a significant role. If your mother, aunt, or sister has PCOS, your risk of developing it is higher. It tends to run in families, though it does not affect every woman in a family equally.
Low-grade inflammation has also been linked to PCOS. Research suggests that women with PCOS have chronic low-level inflammation that stimulates the ovaries to produce excess androgens.
Lifestyle factors such as poor diet, physical inactivity, and stress do not cause PCOS directly, but they can worsen symptoms — particularly in girls who are already predisposed to it.
What Are the Signs of PCOS?
PCOS presents differently in different people. Not every girl will have all of these symptoms, and the severity varies widely. Common signs include:
Irregular or absent periods This is the most common symptom. A girl with PCOS may have fewer than eight periods a year, or go months without one. Some girls have very heavy and painful periods when they do occur. If your daughter started her period but it has always been unpredictable, this is worth investigating.
Excess hair growth (hirsutism) Elevated androgen levels can cause hair to grow in places where women typically have little or no hair — the face (upper lip, chin), chest, stomach, or inner thighs. This symptom causes significant distress for many girls and is often dismissed as a cosmetic issue rather than a medical signal.
Acne Persistent acne — particularly on the jawline, chin, and neck — that does not respond well to regular skincare products may be hormonally driven. In PCOS, high androgen levels stimulate the skin’s oil glands, leading to recurring breakouts.
Weight gain or difficulty losing weight Many girls with PCOS find it difficult to maintain a healthy weight, particularly around the abdomen, even when eating normally. This is closely linked to insulin resistance.
Thinning hair or hair loss Some girls experience thinning hair on the scalp (similar to male-pattern baldness), which can be distressing and is often one of the last symptoms to be connected to PCOS.
Darkening of the skin Patches of dark, velvety skin — often found in skin folds like the neck, underarms, or groin — are called acanthosis nigricans and are associated with insulin resistance in PCOS.
Fatigue and mood changes Many girls with PCOS report persistent tiredness, difficulty concentrating, anxiety, and low mood. These are not imagined — they are real physiological effects of hormonal imbalance.
Can PCOS Affect Young Girls?
Yes — and this is important.
PCOS can begin as early as the first menstrual period. In Nigeria, where awareness of the condition is limited, many girls are told that irregular periods are “normal” or that they will “sort themselves out with age.” Sometimes this is true. But when irregular periods are accompanied by other symptoms — acne, weight changes, excess hair — PCOS should be considered.
Early diagnosis matters because untreated PCOS in adolescence can lead to:
- Increased risk of type 2 diabetes
- Elevated blood pressure
- Long-term fertility challenges (though most women with PCOS can conceive with proper support)
- Anxiety and depression
- Metabolic syndrome
The good news is that PCOS is very manageable, especially when identified early.
How Is PCOS Diagnosed?
There is no single definitive test for PCOS. Diagnosis is based on what is called the Rotterdam Criteria — a girl or woman is considered to have PCOS if she meets at least two of the following three criteria:
- Irregular or absent ovulation (reflected in irregular or absent periods)
- Signs of elevated androgens (either symptoms like excess hair growth, or a blood test confirming high androgen levels)
- Polycystic ovaries on an ultrasound scan
A healthcare provider will typically conduct:
- A physical examination
- Blood tests to check hormone levels, blood sugar, and cholesterol
- A pelvic ultrasound to look at the ovaries
It is important that girls and their parents advocate for proper testing rather than accepting a dismissal of their symptoms.
How Is PCOS Managed?
PCOS has no cure, but its symptoms can be effectively managed through a combination of lifestyle changes and, where necessary, medical treatment.
Lifestyle modifications are the first line of management:
- A balanced diet low in refined sugars and processed foods helps reduce insulin resistance. Traditional Nigerian diets rich in vegetables, legumes, whole grains, and lean proteins are excellent foundations.
- Regular physical activity — even 30 minutes of walking most days — significantly improves insulin sensitivity and helps regulate hormones.
- Adequate sleep and stress management also play a role in hormonal balance.
Medical treatment depends on the specific symptoms:
- Hormonal contraceptives (the pill) are often prescribed to regulate periods and reduce androgen levels. Parents should understand that recommending this for a teenage girl is about managing a medical condition, not encouraging sexual activity.
- Metformin, a diabetes medication, is used to address insulin resistance in PCOS.
- Specific medications can target excess hair growth or acne when these are significant concerns.
What Should Parents Do If They Suspect PCOS?
If you notice that your daughter has irregular periods combined with any of the other symptoms described above, take the following steps:
- Listen without judgment. Many girls feel embarrassed or ashamed of their symptoms. Create a safe space for her to talk openly.
- Visit a healthcare provider. Ask specifically for PCOS to be considered. You may need to see a gynaecologist or endocrinologist.
- Track her menstrual cycle. Keeping a record of her period dates, flow, and associated symptoms will help the doctor assess her situation more accurately.
- Reassure her. PCOS is common, manageable, and not her fault. Many women with PCOS live full, healthy lives.
A Note to Girls Reading This
If you recognise yourself in this article — if your periods have always been unpredictable, if you have struggled with acne or unexplained weight changes or hair where you did not expect it — please know this: something is not wrong with you as a person. Your body is sending you a signal that it needs support.
You deserve accurate information. You deserve to be listened to by a healthcare provider. And you deserve to understand what is happening in your own body.
The Endocrine Health Foundation is here to help you find that support. Reach out to us through our contact page or WhatsApp — our team will help connect you with the right care.
This article is for educational purposes only and does not replace professional medical advice. If you or your daughter are experiencing symptoms described above, please consult a qualified healthcare provider.
