Polycystic Ovary Syndrome in Adolescence

Abstract

Polycystic ovary syndrome (PCOS) is a common, complex, and chronic condition that presents many diagnostic and management challenges for managing clinicians. PCOS diagnosis in adolescents presents a particular challenge for treating clinicians due to the overlap of diagnostic features with normal physiological changes during adolescence. Adolescent diagnostic criteria include well-defined menstrual irregularity according to time postmenarche and hyperandrogenism, but does not require the use of pelvic ultrasound. Adolescents with only one criterion should be considered at risk of PCOS and be followed up around transition to adult care. While PCOS was traditionally considered to be a reproductive disorder, PCOS is now recognized to have major metabolic and cardiovascular health consequences and psychological sequelae that can be present from adolescence. Management of PCOS includes healthy lifestyle, metformin, combined oral contraceptive pill, and/or antiandrogens according to symptoms of concern even in adolescents at risk of PCOS.

Polycystic Ovary Syndrome: Pathophysiology and Controversies in Diagnosis

“…Although PCOS has relatively well-defined clinical, biochemical, and ultrasound-based markers in adult females, the symptoms in adolescents may overlap with those of normal puberty, making a diagnosis challenging. It is crucial to differentiate between conventional adolescence and real ovarian hyperandrogenism, both of which are correlated with the risk of other health conditions such as diabetes type 2 and cardiovascular disorders [37,86].…”