5 min readSep 24, 2026 12:35 PM IST
An ongoing school-based screening programme at the All-India Institute of Medical Sciences (AIIMS), Delhi, has found that nearly one in five of almost 4,000 schoolgirls reported some form of menstrual irregularity. The study, which began around 2023 across seven government and private schools in Delhi, found that an estimated 3-5 per cent of those screened may have polyendocrine metabolic ovarian syndrome (PMOS), the condition previously known as polycystic ovary syndrome (PCOS).
The Indian Express spoke to Dr Rajni Sharma, professor in the Division of Paediatric Endocrinology at AIIMS, about what the findings mean, how parents can distinguish normal menstrual variation from a problem requiring medical attention, and why early identification matters. Edited excerpts:
From a gynaecologist’s perspective, what could explain the high proportion of menstrual irregularity among the girls surveyed?
Irregular cycles can have several causes — thyroid disorders, congenital adrenal hyperplasia, which is a genetic condition affecting the adrenal glands; PMOS, the condition previously known as PCOS; hyperprolactinemia, or abnormally high levels of the hormone prolactin; and other underlying conditions. Apart from genetic factors, unhealthy eating, a sedentary lifestyle, poor sleep and excessive screen time have a major role to play in the development of PMOS in adolescents.
How can parents distinguish normal menstrual irregularity after menarche from a problem that needs medical evaluation?
Cycles can be variable during the pubertal transition, particularly in the first year after menarche (a girl’s first period). That alone is not a red flag. The concern arises when irregularity persists. Between one and three years after menarche, a cycle shorter than 21 days or longer than 45 days is considered irregular. Beyond three years, the range is tighter — anything shorter than 21 days or longer than 35 days needs a closer look. At any point more than a year after menarche, if a single cycle stretches beyond three months, that is a clear signal to consult a doctor.
What are the common causes of repeatedly missed or irregular periods in adolescent girls?
There is rarely a single explanation. That’s exactly why we need to look at the girl’s health as a whole.
Why is early identification of PMOS in adolescent girls important?
Early identification matters because PMOS is not simply a menstrual or ovarian disorder. The new terminology reflects the condition’s broader hormonal and metabolic effects. It is associated with an increased risk of problems including prediabetes, dyslipidemia, fatty liver, hypertension and obesity, as well as future fertility problems and mental health concerns.
For adolescents, menstrual irregularity may be one of the first signs that prompts further assessment. Identifying girls who may have PMOS gives doctors an opportunity to assess their hormonal and metabolic health, address modifiable lifestyle factors and monitor them over time.
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What are the health consequences if repeated missed periods are left unaddressed?
If a girl repeatedly misses periods and the underlying cause isn’t identified and managed, there are real downstream concerns — for bone health, hormonal health and eventually fertility.
When should parents take a teenage girl to a doctor rather than wait for her cycle to normalise?
Parents should consult a doctor if cycles remain irregular a year after menarche, going by the ranges I mentioned, or if a girl develops excessive facial hair or severe acne. These are signs that mean she should see a doctor rather than simply waiting for the cycle to normalise.
Are stress, academic pressure, screen time and poor sleep important contributors?
All of them. However, prevalence estimates for adolescents need to be interpreted carefully, because the criteria for diagnosing PMOS in this age group have become stricter.
AIIMS currently cites a prevalence range of roughly 3-8 per cent among adolescents aged 10-19, compared with older estimates in some settings that put the figure closer to 10 per cent. Globally, the WHO estimates that the condition affects 10-13 per cent of women of reproductive age, with up to 70 per cent of cases going undiagnosed.
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For parents concerned about a child’s menstrual cycle, AIIMS offers a dedicated paediatric endocrinology OPD on Tuesdays and Fridays in Room C-207. The institute is also conducting an ICMR-backed study on healthy lifestyle education and non-hormonal therapy for girls with PMOS, with investigations and treatment provided free of cost.
The focus is on early recognition and management — identifying girls who may need further assessment and intervention before menstrual irregularity is accompanied by longer-term metabolic, hormonal and reproductive complications.
