title: New adolescent polycystic ovary syndrome perspectives.
abstract: Polycystic ovary syndrome (PCOS) is a common but heterogeneous disorder that usually arises during puberty. This endocrine disorder is associated with chronic anovulation and hyperandrogenemia with clinical manifestation of oligomenorrhea, hirsutism and acne. While the underlying etiology of PCOS remains unknown, it is commonly associated with obesity and insulin resistance leading to increased risk of cardiovascular disease, dyslipidemia and type 2 diabetes mellitus in hyperandrogenemic phenotypes. Menstrual irregularities and insulin resistance in obese adolescents are usually indistinguishable from the clinical manifestations of PCOS and pose a diagnostic dilemma due to higher circulating androgens during puberty. Consequently, a universal consensus on the definition of hyperandrogenemia in adolescents has been elusive. Nevertheless, hyperandrogenemia, independent of obesity, in postmenarchal adolescents is associated with increased risk of cardiometabolic syndrome. Therefore, treatment strategies including lifestyle changes and/or use of insulin-sensitizers, hormone replacement and antiandrogens should be utilized in order to delay long-term cardiovascular and metabolic complications of this endocrinopathy.
authors.affiliation: Department of Pediatrics, Section of Endocrinology and Diabetes, Medical College of Wisconsin, Milwaukee, WI 53226, USA. ralemzad@mcw.edu
authors.forename: R
authors.initials: R
authors.lastname: Alemzadeh
authors.forename: A R
authors.initials: AR
authors.lastname: Kansra
mesh_terms: D000152:Acne Vulgaris / Q000209:etiology; D000293:Adolescent; D000465:Algorithms; D000726:Androgen Antagonists / Q000627:therapeutic use; D000858:Anovulation / Q000175:diagnosis / Q000209:etiology; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000150:complications; D003270:Contraceptive Agents / Q000627:therapeutic use; D048909:Diabetes Complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D004359:Drug Therapy, Combination; D005081:Exercise Therapy; D005260:Female; D006628:Hirsutism / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D024821:Metabolic Syndrome / Q000150:complications; D009765:Obesity / Q000150:complications; D009839:Oligomenorrhea / Q000175:diagnosis / Q000209:etiology; D011085:Polycystic Ovary Syndrome / Q000150:complications* / Q000175:diagnosis* / Q000235:genetics / Q000503:physiopathology / Q000628:therapy; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists; D003270:Contraceptive Agents; D007004:Hypoglycemic Agents