Menstrual Irregularity and Poly Cystic Ovarian Syndrome among Adolescent Girls—A 2 Year Follow-up Study

Nair, M. K. C.; Pappachan, Princly; Balakrishnan, Sheila; Leena, M. L.; George, Babu; Russell, Paul Swamidhas Sudhakar

doi:10.1007/s12098-011-0432-y

Cited by 55 publications

(44 citation statements)

References 18 publications

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“…While menstrual irregularity is common, its persistence after 2 years after menarche is associated with PCOS. Nair et al 51 studied a cohort of 136 adolescent girls with confirmed menstrual irregularity; at 2 year follow-up, 51.5% continued to have menstrual irregularity and 36% were diagnosed with PCOS using the Rotterdam criteria. In their cohort, Roe et al 70 found that 98% of adolescents diagnosed with PCOS by the AE-PCOS criteria presented with menstrual irregularity—68.3% with oligomenorrhea, 27.7% with secondary amenorrhea, and 4% with primary amenorrhea.…”

Section: Menstrual Irregularitymentioning

confidence: 99%

Diagnosis and Challenges of Polycystic Ovary Syndrome in Adolescence

et al. 2014

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Although the diagnostic criteria for polycystic ovary syndrome (PCOS) have become less stringent over the years, determination of the minimum diagnostic features in adolescents is still an area of controversy. Of particular concern is that many of the features considered to be diagnostic for PCOS may evolve over time and change during the first few years after menarche. Nonetheless, attempts to define young women who may be at risk for development of PCOS is pertinent since associated morbidity such as obesity, insulin resistance, and dyslipidemia may benefit from early intervention. The relative utility of diagnostic tools such as persistence of anovulatory cycles, hyperandrogenemia, hyperandrogenism (hirsutism, acne, or alopecia), or ovarian findings on ultrasound is not established in adolescents. Some suggest that even using the strictest criteria, the diagnosis of PCOS may not valid in adolescents younger than 18 years. In addition, evidence does not necessarily support that lack of treatment of PCOS in younger adolescents will result in untoward outcomes since features consistent with PCOS often resolve with time. The presented data will help determine if it is possible to establish firm criteria which may be used to reliably diagnose PCOS in adolescents.

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Section: Menstrual Irregularitymentioning

confidence: 99%

Diagnosis and Challenges of Polycystic Ovary Syndrome in Adolescence

et al. 2014

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“…Additionally, the reproductive capacity of adolescents also undergoes non-pathological changes during pubertal development that are influenced by the secretion of gonadotropins. These changes are expressed by irregular menstrual patterns and PCOM on ultrasonography, and may even persist for 2 years after menarche [2,15,16,17]. Because all three sets of criteria include abnormal ovulatory patterns and PCOM, the diagnosis in adolescence remains challenging.…”

Section: Pcos In Adolescentsmentioning

confidence: 99%

“…Lately, however, at least some cases of PCOS have been regarded as a disorder of metabolic origin that impairs reproductive function [5]. Since obesity, particularly in the abdominal region, is found in ∼50% [9,29] of women with PCOS, and because obesity appears in mid-childhood and increases during puberty [6,16,27], excess adiposity has generated a great deal of attention. Furthermore, the clinical phenotype and the development of PCOS are thought to be reinforced by obesity [2,7,27,30], especially among those who are genetically prone to the disorder [7].…”

Section: Biological Originmentioning

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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“…Most prevalence studies in India are in hospital set-ups and recently a few studies among adolescents in schools report prevalence of PCOS as 9.13% to 36%. [1415] It is appropriately pointed by Gainie and Kalra[16] that the health budget of India is unlikely to meet the costs posed to tackling the associated multiple consequences of PCOS. It is time that this warning is heeded and at national level the disease is recognized as an important noncommunicable disease.…”

Section: Introductionmentioning

confidence: 99%

A cross-sectional study of polycystic ovarian syndrome among adolescent and young girls in Mumbai, India

Joshi

Mukherjee

Patil

et al. 2014

Indian J Endocr Metab

167

146

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Introduction:Polycystic ovary disease is a common endocrine condition which is rapidly gaining epidemic proportions. No community based prevalence data is available for this syndrome in India.Materials and Methods:A cross-sectional community-based study was undertaken in a sampled census block of Mumbai to assess the prevalence of polycystic ovarian syndrome (PCOS) among 778 adolescents and young girls aged 15-24 years. Among them, 600 completed all clinical, ultrasonography (USG), and biochemical investigations.Results:The prevalence of PCOS among them was 22.5% by Rotterdam and 10.7% by Androgen Excess Society criteria. Nonobese comprised 71.8% of PCOS diagnosed by Rotterdam criteria. Mild PCOS (oligomenorrhea and polycystic ovaries on USG) was the most common phenotype (52.6%). History of oligomenorrhea had a positive predictive value of 93.3% and negative predictive value of 86.7% to detect a possible case of PCOS. Hyperinsulinemia (serum insulin >15 μlU/mL) was present among 19.2% of diagnosed PCOS cases. Obese girls with PCOS were more hirsute, hypertensive, and had significantly higher mean insulin and 2 h post 75 g glucose levels compared with nonobese PCOS.Conclusion:To our knowledge, this is the first urban community-based study diagnosing PCOS and phenotypes among adolescent and young girls in India. This study demonstrates that PCOS is an emerging disorder during adolescence and screening could provide opportunity to target the group for promoting healthy lifestyles and early interventions to prevent future morbidities.

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Menstrual Irregularity and Poly Cystic Ovarian Syndrome among Adolescent Girls—A 2 Year Follow-up Study

Abstract: The results of this study support screening for menstrual irregularity, obesity and signs of clinical hyperandrogenism for early diagnosis of PCOS in an effort to improve the reproductive health of adolescent girls.

Cited by 55 publications

References 18 publications

Diagnosis and Challenges of Polycystic Ovary Syndrome in Adolescence

Diagnosis and Challenges of Polycystic Ovary Syndrome in Adolescence

Development of Obesity and Polycystic Ovary Syndrome in Adolescents

A cross-sectional study of polycystic ovarian syndrome among adolescent and young girls in Mumbai, India

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