A rational approach to the diagnosis of polycystic ovarian syndrome during adolescence

Merino, Paulina M.; Codner, Ethel; Cassorla, Fernando

doi:10.1590/s0004-27302011000800013

Cited by 27 publications

(23 citation statements)

References 69 publications

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“…Severity of acne using 10 points on the visual analogue scale (≥6 points was considered as severe), seborrhea and alopecia (the clinical markers of hyperandrogenism) were also assessed. Abnormal menstrual cycles (longer than 45 days) were defined according to guidelines of the American College of Obstetricians and Gynecologists [18]. Ultrasonographic ovary imaging was performed using a transabdominal transducer (3.5 MHz), Siemens Acuson X500 Ultrasound System.…”

Section: Methodsmentioning

confidence: 99%

Circulating Anti-Müllerian Hormone Levels in Daughters of Women with and without Polycystic Ovary Syndrome

Olszanecka-Glinianowicz¹,

Zachurzok

Drosdzol–Cop

et al. 2016

Horm Res Paediatr

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Background/Aims: The aim of this study was to assess whether circulating anti-Müllerian hormone (AMH) levels in daughters of women with polycystic ovary syndrome (PCOSd) correspond with clinical and biochemical features of hyperandrogenism, polycystic ovary morphology and menstrual cycle disturbances. Methods: Menstrual cycle disturbances, hirsutism, acne and ultrasonographic ovarian morphology were assessed in 75 girls aged 13-18 years (35 PCOSd and 40 daughters of healthy women). Serum gonadotropins, androgens, sex hormone-binding globulin and plasma AMH were measured in a fasting state, and the free androgen index was calculated. Results: A significant correlation between the AMH level and mean ovary volume was found (r = 0.36; p < 0.01). AMH levels were not related to hirsutism, acne and polycystic ovary morphology. Significantly higher AMH levels were found only in PCOSd with irregular menstruation or secondary amenorrhea. The results of logistic regression analysis showed that in that group for each 1-ng/ml increase in the AMH level, the odds ratio of the PCOS occurrence in the future was increased 1.27 times (95% CI: 1.09-1.47; p < 0.01). Conclusions: A higher AMH level in PCOSd is associated with menstrual cycle disturbances and larger ovarian volume but not with clinical and biochemical features of hyperandrogenism. Thus, the risk for PCOS development among genetically predisposed girls may be related to increased AMH levels.

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Section: Methodsmentioning

confidence: 99%

Circulating Anti-Müllerian Hormone Levels in Daughters of Women with and without Polycystic Ovary Syndrome

Olszanecka-Glinianowicz¹,

Zachurzok

Drosdzol–Cop

et al. 2016

Horm Res Paediatr

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“…In a sample of 250 adolescent girls, PCOS was best characterized by clinical HA (hirsutism) and/or biochemical HA and oligomenorrhea [18]. Other groups have suggested that menstrual patterns are classified as pathological in adolescents when menstruation is absent for ≥90 days, or if cycles persist for ≥45 days [19]. Biochemically, HA can be determined by levels of cFT, and dehydroepiandrosterone in adolescent girls [19].…”

Section: Pcos In Adolescentsmentioning

confidence: 99%

“…Other groups have suggested that menstrual patterns are classified as pathological in adolescents when menstruation is absent for ≥90 days, or if cycles persist for ≥45 days [19]. Biochemically, HA can be determined by levels of cFT, and dehydroepiandrosterone in adolescent girls [19]. Physiologically, ovarian volume and antral follicle count can be assessed by transabdominal ultrasonography, although these measures may be operator dependent and also of limited use in adolescents [2].…”

Section: Pcos In Adolescentsmentioning

confidence: 99%

Development of Obesity and Polycystic Ovary Syndrome in Adolescents

Vilmann¹,

Thisted²,

Baker³

et al. 2012

Horm Res Paediatr

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Obesity in adolescents is prevalent worldwide. Polycystic ovary syndrome (PCOS) is often associated with obesity in women, and it has serious metabolic and reproductive health implications. Although PCOS does not become clinically visible until early adolescence, its origins are likely much earlier. Therefore, we reviewed the recent literature regarding the mechanisms linking the development of PCOS and obesity in adolescent girls. We found that excess abdominal adipose tissue (AT) initiates metabolic and endocrine aberrations that are central in the progression of PCOS. As an example, abdominal AT impairs insulin action, which interacts with the progression of hyperandrogenism. In addition, excessive androgen levels lead to impaired glucose uptake, which also contributes to insulin resistance, which again increases the deposition of visceral fat. The body composition is influenced by testosterone, which decreases subcutaneous fat lipolysis and influences adipocyte distribution. These mechanisms may explain why PCOS girls have an increased visceral adipose mass independent of body mass index. Therefore, first-line treatment in adolescent PCOS is often lifestyle intervention to prevent the damaging effects of obesity. Pharmacological treatment of adolescent PCOS is not standardized because the long-term effects in adolescents have not yet been evaluated; therefore, drugs should be prescribed cautiously. Although the complex metabolic interrelationships between obesity and PCOS have yet to be fully understood, the co-occurrence of these conditions in adolescent girls tends to increase the severity of the negative health consequences of each condition.

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“…Acne and seborrhea are common, but alopecia is rare in adolescence [25] . Hirsut-ism reflects the interaction between circulating androgen concentrations, local androgen concentrations, and the apparent sensitivity of the pilosebaceous unit/hair follicle to androgens.…”

Section: Introductionmentioning

confidence: 99%

The Diagnosis of Polycystic Ovary Syndrome during Adolescence

et al. 2015

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dress a series of questions regarding the diagnosis of PCOS during adolescence including the following: clinical and biochemical evidence of hyperandrogenism, criteria for oligoanovulation and polycystic ovary morphology, diagnostic criteria to exclude other causes of hyperandrogenism and amenorrhea, role of insulin resistance, and intervention. Results and Conclusion: Features of PCOS overlap normal pubertal development. Hence, caution should be taken before diagnosing PCOS without longitudinal evaluation. However, treatment may be indicated even in the absence of a definitive diagnosis. While obesity, insulin resistance, and hyperinsulinemia are common findings in adolescents with hyperandrogenism, these features should not be used to diagnose PCOS among adolescent girls. © 2015 S. Karger AG, Basel Key WordsHyperandrogenism · Ovarian hyperandrogenism · Ovary · Polycystic ovary syndrome · Puberty Abstract Background/Aims: The diagnostic criteria for polycystic ovary syndrome (PCOS) in adolescence are controversial, primarily because the diagnostic pathological features used in adult women may be normal pubertal physiological events. Hence, international pediatric and adolescent specialty societies have defined criteria that have sufficient evidence to be used for the diagnosis of PCOS in adolescents. Methods: The literature has been reviewed and evidence graded to ad-

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A rational approach to the diagnosis of polycystic ovarian syndrome during adolescence

Cited by 27 publications

References 69 publications

Circulating Anti-Müllerian Hormone Levels in Daughters of Women with and without Polycystic Ovary Syndrome

Circulating Anti-Müllerian Hormone Levels in Daughters of Women with and without Polycystic Ovary Syndrome

Development of Obesity and Polycystic Ovary Syndrome in Adolescents

The Diagnosis of Polycystic Ovary Syndrome during Adolescence

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