How are acne, hair loss, and irregular periods linked?

Question

Hello doctor,

My cousin is only 21, but she is been struggling with severe acne all over her face and back for the past year. She is also experiencing significant hair thinning, especially around her temples. Her periods have become irregular - sometimes she skips months entirely. She is always been healthy and active, so this is concerning for our whole family. What could be causing all these symptoms in someone so young? Is there a connection between acne, hair loss, and menstrual irregularities? We are looking for ways to help her manage these issues before they get worse.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Let me explain about the symptoms. According to the information given by you, I think your cousin might be suffering from a condition known as PCOS (Polycystic ovary syndrome). The criteria to diagnose this condition are called the Rotterdam criteria

Polycystic ovaries (either 12 or more follicles or increased ovarian volume (> 10 cubic centimeters)
Oligo-ovulation or anovulation, which means like absence of menses for 2-3 months
Clinical and or biochemical signs of hyperandrogenism. Clinical features of hyperandrogenism include hirsutism, characterised by excess facial and body hair.
Hair and midline hair growth. Although free and total testosterone are used in the diagnosis of PCOS.
Unwanted hair loss and acne.

I will advise you to do the following investigations

Serum FSH (follicle-stimulating hormone) & LH (Luteinizing hormone) on the 2nd day of the period.
Serum prolactin.
Serum thyroid function test.
Ultrasound pelvic.

Management:

Diet control and avoid spicy and oily food.
Exercise regularly.
Tablet Metformin (anti-diabetic medicine for insulin resistance) 500 mg, twice daily for a month

Tablet Dydrogesterone (progestin medication) 10mg, twice daily for 21 days, followed by a 7-day pill-free interval for 3 months.

I hope this information helps you.

Feel free to ask further queries.

Thank you.