Diagnosis and treatment of polycystic ovarian syndrome in adolescents.
OBJECTIVE
To review what is understood about the pathophysiology of polycystic ovarian syndrome (PCOS), the diagnostic challenges of PCOS in adolescent women, associated risk factors, as well as the best evidence-based treatment options for adolescence.


RESULTS
Diagnosing PCOS in adolescents requires a unique set of criteria for which no single marker currently exists. Adolescents at high risk for developing the syndrome are congenital virilization, low birth weight, premature pubarche, central precocious puberty, large for gestational age girls born to overweight mothers, obesity syndromes, insulin-resistant features, and girls born to parents with PCOS, central obesity, or diabetes in whom PCOS ought to be suspected when associated with irregular menses. Insulin, hyperandrogenemia, and adipocytokines are integral players in the pathophysiology of PCOS. PCOS may be an inheritable trait; however, no gene has yet been identified. Quality of life remains a concern for young women with PCOS. Lifestyle modifications geared to prevent long-term sequelae remain the first-line treatment in conjunction with oral contraceptive pills.


CONCLUSIONS
Identifying PCOS in adolescents remains a diagnostic dilemma, but early intervention and treatment can improve long-term health.
School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA.
Katrina F
KF
Nicandri
Kathleen
K
Hoeger
D000293:Adolescent; D016497:Adolescent Health Services; D001828:Body Image / Q000523:psychology; D003278:Contraceptives, Oral, Hormonal / Q000008:administration & dosage* / Q000494:pharmacology; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D007333:Insulin Resistance; D008599:Menstruation Disturbances / Q000209:etiology; D009765:Obesity / Q000150:complications / Q000517:prevention & control*; D011085:Polycystic Ovary Syndrome / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology; D011788:Quality of Life; D012307:Risk Factors; D040242:Risk Reduction Behavior
D003278:Contraceptives, Oral, Hormonal