New Criteria for the Clinical Diagnosis of Hyperandrogenism in Polycystic Ovarian Syndrome and the Risk of Overdiagnosis

Soares-Jr, José Maria; Sá, Marcos Felipe Silva de; Baracat, Edmund Chada

doi:10.1055/s-0039-1693530

Cited by 5 publications

(15 citation statements)

References 13 publications

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“…6 Its main evaluation tool for diagnosis and follow-up is the modified Ferriman Gallwey (FG) score, whose cutoff depends both on the age and ethnicity of the girl. 6 16 In fact, it is expected that girls with Mediterranean, Hispanic or Middle Eastern origins develop a more severe hirsutism, whereas adolescents from East Asia tend to have milder forms. 19 The classical cutoff point of ≥ 8 is widely found in the literature to establish clinical hyperandrogenism.…”

Section: Hyperandrogenismmentioning

confidence: 99%

“…3 16 17 Finally, care must be taken to make a correct differential diagnosis between clinical hyperandrogenism and other forms of excessive hair growth, namely hypertrichosis and lanugo to avoid unnecessary treatments. 6…”

Section: Hyperandrogenismmentioning

confidence: 99%

“…Another possible explanation for this finding relies on an exacerbated action of the androgens in effector organs (hair follicle) rather than on a significant elevation of its circulating levels. 6 Also, one must not forget that combined oral contraceptives affect SHBG and alter gonadotrophin-dependent androgen production. Thus, a reliable assessment of biochemical hyperandrogenism requires withdrawal of these therapeutic agents at least 3 months before measurement, providing another mean of contraception for sexually active adolescents.…”

Section: Hyperandrogenismmentioning

confidence: 99%

“…Hyperandrogenemia per se might increase the production of free radicals, thereby disturbing redox balance toward the pro-oxidant state leading to early subtle clinical manifestations. 4 6…”

Section: Introductionmentioning

confidence: 99%

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Polycystic Ovary Syndrome in Adolescence: Challenges in Diagnosis and Management

Manique

Póvoa

2022

Rev Bras Ginecol Obstet

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Diagnosing polycystic ovary syndrome (PCOS) during adolescence is challenging since normal pubertal development overlap typical features of this syndrome. The authors aim to summarize the existing evidence concerning PCOS in adolescence, particularly its diagnostic criteria and therapeutic options. A search throughout medical databases such as PubMed and MedScape was performed. Diagnostic criteria include irregular menstrual cycles according to time postmenarche and evidence of clinical hyperandrogenism and/or biochemical hyperandrogenism, provided other causes have been excluded. Polycystic ovarian morphology ought not to be used as a diagnostic criterion. Treatment should target manifestations and/or comorbidities, even in the absence of a definite diagnosis. Lifestyle interventions are the first-line treatment. Combined oral contraceptives, metformin or antiandrogens may also be considered as adjuvants. Screening for PCOS in adolescence is crucial as it allows an early intervention on the symptoms and comorbidities presented leading to better long-term reproductive and metabolic outcomes.

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Section: Hyperandrogenismmentioning

confidence: 99%

Section: Hyperandrogenismmentioning

confidence: 99%

Section: Hyperandrogenismmentioning

confidence: 99%

“…Hyperandrogenemia per se might increase the production of free radicals, thereby disturbing redox balance toward the pro-oxidant state leading to early subtle clinical manifestations. 4 6…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Polycystic Ovary Syndrome in Adolescence: Challenges in Diagnosis and Management

Manique

Póvoa

2022

Rev Bras Ginecol Obstet

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“…While these specific changes reduce the risk of overdiagnosis, the newly endorsed criteria still capture many women with few or mild symptoms. The lowered score for hirsutism (excess hair growth) in the 2018 guidelines has also raised concerns5 about overdiagnosis.…”

Section: An Increase In Prevalencementioning

confidence: 99%

Polycystic ovary syndrome: why widening the diagnostic criteria may be harming women

Copp

Doust

McCaffery

et al. 2021

BMJ

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Polycystic ovary syndrome in adolescents with obesity

Fu¹,

Qu²,

Pan³

et al. 2021

Rev. Assoc. Med. Bras.

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INTRODUCTION: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age with the prevalence from 5% to 15%, and the prevalence of PCOS in adolescents with obesity seems even higher. The weight status is significantly associated with the quality of life in adolescents with PCOS.OBJECTIVE: This review aims to summarize the latest findings of pathogenesis, diagnosis, comorbidity, and management in PCOS adolescents with obesity.METHODS: This is a narrative review of articles published in PubMed from June 2013 to June 2020 Data were searched using the key words of "polycystic ovary syndrome" AND "adolescent" AND "obesity." RESULTS:Pubertal obesity, particularly central obesity, could have a negative impact on the pathophysiology of PCOS. In adolescents with obesity, a review of medical history and a long-term follow-up for PCOS symptoms are essential to avoid misdiagnosis. There is a link between obesity and comorbidities of PCOS in adolescents. Holistic treatment and concern for related comorbidities should ideally begin as early as possible in obese adolescents once the diagnosis of PCOS is confirmed.CONCLUSION: Adolescents with PCOS and obesity need more attention from physicians and researchers, and the effective interventions in the early stage are critical to improve their life quality.

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New Criteria for the Clinical Diagnosis of Hyperandrogenism in Polycystic Ovarian Syndrome and the Risk of Overdiagnosis

Cited by 5 publications

References 13 publications

Polycystic Ovary Syndrome in Adolescence: Challenges in Diagnosis and Management

Polycystic Ovary Syndrome in Adolescence: Challenges in Diagnosis and Management

Polycystic ovary syndrome: why widening the diagnostic criteria may be harming women

Polycystic ovary syndrome in adolescents with obesity

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