Polycystic ovary Syndrome in Adolescents: Pitfalls in Diagnosis and Management

AbstractPurpose of ReviewPolycystic ovary syndrome (PCOS) is the commonest endocrine disorder during a woman ’s reproductive lifespan, with well-documented diagnostic criteria and therapeutic strategies in adults; the same is not necessarily true for adolescents. The purpose of this review was to identify frequent pitfalls in PCOS diagnosis and management during adolescence.Recent FindingsAlthough there is no global consensus on the definition, most experts converge to the presence of both oligo/amenorrhea and (clinical and/or biochemical) hyperandrogenism, as a prerequisite for diagnosis in adolescents. The former criterion includes: (a) consecutive menstrual intervals> 90 days even in the first year after menarche; (b) menstrual intervals persistently< 21 or> 45 days for ≥ 2 years after menarche; or (c) lack of menses by the age of 15 or 2–3 years after pubarche. However, these menstrual irregularity patterns may overlap with other common entities in adolescents, such as frequent or infrequent uterine bleeding or anovulation due to immaturity of the hypothalamic -pituitary-ovarian axis. Clinical signs of hyperandrogenism are obscure, without well-validated criteria. Finally, the criterion of polycystic morphology cannot be safely used in adolescents, mostly due to technical limitations of the transabdominal ultrasound. Except for the efficacy of lifestyle i ntervention in overweight and obese adolescents with PCOS, limited and low-quality data exist regarding...
Source: Current Obesity Reports - Category: Eating Disorders & Weight Management Source Type: research