Interventional Studies for Polycystic Ovarian Syndrome in Children and Adolescents

Abstract

Polycystic ovarian syndrome (PCOS) is characterized by chronic anovulation, clinical and/or biochemical hyperandrogenism, which can be associated with altered insulin action. Symptoms usually begin around menarche, but onset after puberty may also occur as a result of environmental modifiers such as weight gain. The consequences of PCOS extend beyond the reproductive axis; there is a substantial risk for development of metabolic and cardiovascular abnormalities similar to the metabolic syndrome. Currently, the treatment is targeted to the patient’s primary complaint such as hirsutism, restoration of regular menses or pregnancy. Pharmacological agents available for the treatment of hirsutism include androgen suppressors and peripheral androgen blockers. Recently, our understanding of the role of insulin resistance has led to the use of insulin-sensitizing medications as first-choice therapy. In conjunction with weight reduction and exercise, a pharmacologic reduction in insulin levels by either metformin or thiazolidinediones ameliorates both hyperinsulinemia and hyperandrogenism.

Health‐Related Quality of Life Among Adolescents with Polycystic Ovary Syndrome

“…Although the symptoms of PCOS typically begin around menarche (Vuguin, 2010), no qualitative studies and only four quantitative studies (Harris-Glocker, Davidson, Kochman, Guzick, & Hoeger, 2010;Trent, Austin, Rich, & Gordon, 2005;Trent, Rich, Austin, & Gordon, 2002;Trent, Rich, Austin, & Gordon, 2003) have focused on the impact of PCOS on the HRQoL of adolescents with the condition. However, three of these studies present data from the same cohort (Trent et al, 2002(Trent et al, , 2003(Trent et al, , 2005, and Harris-Glocker et al (2009) were narrowly focused on assessing the impact of metformin versus placebo in a lifestyle modification program combined with oral contraceptives in obese adolescents with PCOS.…”

“…Although the symptoms of PCOS typically begin around menarche (Vuguin, ), no qualitative studies and only four quantitative studies (Harris‐Glocker, Davidson, Kochman, Guzick, & Hoeger, ; Trent, Austin, Rich, & Gordon, ; Trent, Rich, Austin, & Gordon, ; Trent, Rich, Austin, & Gordon, ) have focused on the impact of PCOS on the HRQoL of adolescents with the condition. However, three of these studies present data from the same cohort (Trent et al., , , ), and Harris‐Glocker et al.…”

Association between circulating adiponectin levels and polycystic ovarian syndrome

“…Clinical features of PCOS namely hirsutism, acne, and alopecia originate from high circulating levels of androgens, menstrual irregularities from anovulatory cycles [ 2 ], and obesity is thought to originate from both the underlying IR [ 1 ] and high androgen levels in these patients [ 3 ]. The alarming tribulations associated with the syndrome are past the reproductive axis and these women are at a greater risk of developing the metabolic syndrome at an early age because of IR and obesity [ 4 - 6 ] observed in 30-60% of PCOS patients [ 7 ].…”

Myo-Inositol in the Treatment of Teenagers Affected by PCOS

“…Adolescents with PCOS tend to be troubled by the cosmetic effects, such as acne, hirsutism, acanthosis nigricans, and obesity. They occur during a particularly vulnerable stage of their psychological development [ 7 ].…”

“…Adolescent girls with PCOS require a long-term committed treatment that can have serious side effects. Therefore, alternative treatments may be possible options for adolescents affected by PCOS [ 7 ].…”