Management of polycystic ovary syndrome in childhood and adolescence.
BACKGROUND
Polycystic ovary syndrome (PCOS) is a common endocrinopathy in women. It may manifest as early as in the first decade of life. Most often it becomes clinically apparent during adolescence with maturation of the hypothalamic-pituitary-ovarian axis.


METHODS
Typical features in adolescence include irregular menstrual cycles, acne, hirsutism, obesity and signs of insulin resistance such as acanthosis nigricans. Biochemical hyperandrogenism and polycystic ovaries are often present. However, some adolescents have no evidence of clinical and biochemical hyperandrogenism despite dysfunctional polycystic ovaries.


METHODS
The pathogenesis of PCOS is uncertain, however, both genetic and environmental factors play a role, resulting in key features of the syndrome; disordered gonadotropin release, dysregulated steroidogenesis, ovarian and adrenal hyperandrogenism and hyperinsulinism. PCOS is often accompanied by metabolic syndrome, with abnormalities in lipid and glucose metabolism.


METHODS
Treatment of PCOS is symptomatic. Lifestyle changes are a first-line intervention, however, increasing evidence suggests that metformin and estrogen-progestin combination pill may be beneficial.


CONCLUSIONS
PCOS is a lifelong condition that carries long-term health risks. Several risk factors for PCOS have been identified and clinicians should be alert for this condition already in childhood and adolescence. Early intervention and counseling might be the key for prevention of co-morbidities of PCOS.
Ojaniemi
M
M
Department of Pediatrics and Adolescence, Institute of Clinical Medicine, Oulu University Hospital, University of Oulu, Oulu, Finland. marja.ojaniemi@oulu.fi
Tapanainen
P
P
Morin-Papunen
L
L
D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008019:Life Style; D024821:Metabolic Syndrome / Q000150:complications; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D012307:Risk Factors