Treatment of PCOS in adolescence.
Polycystic ovary syndrome (PCOS) is increasingly being recognized in adolescent girls seeking treatment for signs and symptoms of hyperandrogenism. It is difficult to diagnose PCOS in adolescents, therefore a high index of suspicion is necessary. Timely screening and treatment are crucial because another important component of the syndrome is insulin resistance/hyperinsulinemia increasing the risk for type 2 diabetes, dyslipidemia, and cardiovascular sequelae. Diagnosis of PCOS in adolescents should include a thorough family history, exclusion of other causes of hyperandrogenism, and appropriate laboratory evaluation. The scarcity of controlled clinical trials makes treatment controversial. Therapeutic options include lifestyle intervention, oral contraceptive pills, and insulin sensitizers. Long-term follow-up is needed to determine the effectiveness of these approaches in changing the natural history of the reproductive and metabolic outcomes without causing undue harm.
Warren-Ulanch
Julia
J
Division of Endocrinology, University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, 3705 Fifth Avenue, Pittsburgh, PA 15213-2583, USA. warrenulanchjg@upmc.edu
Arslanian
Silva
S
D000293:Adolescent; D000726:Androgen Antagonists / Q000627:therapeutic use; D000858:Anovulation / Q000175:diagnosis; D001786:Blood Glucose / Q000378:metabolism; D001823:Body Composition; D002318:Cardiovascular Diseases / Q000209:etiology; D003276:Contraceptives, Oral / Q000627:therapeutic use; D003924:Diabetes Mellitus, Type 2 / Q000517:prevention & control; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000097:blood / Q000517:prevention & control; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007249:Inflammation / Q000209:etiology; D007333:Insulin Resistance / Q000502:physiology; D011085:Polycystic Ovary Syndrome / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D011629:Puberty, Precocious / Q000175:diagnosis; D040242:Risk Reduction Behavior; D013375:Substance Withdrawal Syndrome / Q000209:etiology; D015431:Weight Loss
D000726:Androgen Antagonists; D001786:Blood Glucose; D003276:Contraceptives, Oral; D007004:Hypoglycemic Agents