Study Seeks Overweight Teens with Menstrual Disorder
Strong Doctor Connects with Girls Before More Serious Issues Arise
November 20, 2002
Dr. Kathy Hoeger knows the last thing teen girls want to talk about is missed menstrual periods, being overweight and embarrassing facial hair growth. But that’s exactly what she is trying to do: Reach out to Rochester adolescents who might have symptoms associated with polycystic ovary syndrome, so they can avoid more serious medical problems that might come later, including infertility.
“Nobody wants this when you’re 15,” says Hoeger, associate professor of Obstetrics and Gynecology at the University of Rochester Medical Center and Strong Memorial Hospital. “But the bottom line is, the earlier we can get a handle on this condition, the better it is for women.”
PCOS is a hormonal disorder that afflicts 5 to 10 percent of all women of childbearing age. Marked by the overproduction of male hormones, it is also associated with high insulin levels. Many teens and women who have PCOS are overweight, a consequence of the hormonal imbalance.
In addition, PCOS causes ovarian changes that prohibit regular ovulation, acne that doesn’t respond to treatment, and can lead to diabetes and heart disease. In some cases, PCOS isn’t properly diagnosed until a woman is unable to get pregnant.
Investigating PCOS is gaining momentum, though, Hoeger says, and she is among the first doctors to study teenagers. The goal of her current research is to enroll 40 to 45 girls from ages 12 to 18 in a six-month clinical trial to compare three treatments.
The first, metformin, is a drug used to manage diabetes by controlling blood sugar. The second, birth control pills, will not be used for contraception, but will be used to induce regular, monthly bleeding. Finally, the study will evaluate whether weight loss is also an effective treatment for PCOS.
The National Institutes of Health funded the $100,000 project. Hoeger has already completed a similar, randomized pilot study in adult women. She presented results in October 2002 at the annual meeting of the American Society of Reproductive Medicine.
That trial, focusing on women with an average age of 28 and average weight of more than 200 pounds, showed that even modest weight loss induced regular ovulation. The women who took metformin and had concurrent weight loss showed the most improvement and were 16 times more likely to shift into a pattern of regular ovulation.
In fact, weight loss seems to be a key ingredient in coping with PCOS. “Weight loss clearly helps reproductive health,” Hoeger says. “And we weren’t aiming for anything as dramatic as a 100-pound reduction. This was a program that simply encouraged healthy lifestyle changes, and we found that women could get benefits in terms of ovulation, from simply losing five percent of their weight.”
As baby boomers age, Hoeger adds, awareness of PCOS is spreading to cardiologists. “They are interested in finding out why some 40-year-old women have significant cardiovascular risk factors that place them at risk for heart attacks. In some cases there is a connection to PCOS,” she says. “It used to be that the idea of being infertile was scary enough. But now we know PCOS is a metabolic disorder that has a link to diabetes and heart disease.”
For more information about the teen study, contact nurse coordinator Lynda Kochman at (585) 273-2995, or Dr. Hoeger at (585) 275-7891. # # #