Opinions in pediatric and adolescent gynecology

Ma, Gold

doi:10.1016/s1083-3188(99)00019-4

Cited by 2 publications

(3 citation statements)

References 14 publications

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“…26,29 Jamieson (2001) stresses the importance of the history, the exam, and the clinical concerns of the patients and implores us not to rely too heavily on endocrine panels for diagnosis and management of the hirsute patient. 29 Infrequently, an adolescent with evidence of hyperandrogenism will have an adrenal or ovarian tumor, nonclassic congenital adrenal hyperplasia, or Cushing syndrome. Hence, common practice is to obtain total and free testosterone and DHEAS, and a 17-hydroxyprogesterone.…”

Section: Discussionmentioning

confidence: 99%

“…In general, tumors are associated with rapid, progressive onset of symptoms and virilization, and the diagnosis is based on history and exam findings, not biochemical evidence. 25,26,29 Approximately 1-8% of hirsute women will have nonclassic congenital adrenal hyperplasia (CAH). An elevated basal 17-hydroxyprogesterone level should prompt an ACTH stimulation test to establish the diagnosis of nonclassic CAH.…”

Section: Discussionmentioning

confidence: 99%

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Polycystic Ovary Syndrome in Adolescence

Driscoll

2003

Annals of the New York Academy of Sciences

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Polycystic ovary syndrome (PCOS) is a common disorder among reproductive-age women, yet the diagnosis may be overlooked during adolescence. Although the clinical and metabolic features are similar to those found in adult women, it can be difficult to distinguish the young woman with PCOS from a normal adolescent. Irregular menses, anovulatory cycles, and acne are not uncommon in adolescent women. Adolescents with a history of premature pubarche, a family history of PCOS, Caribbean-Hispanic and African-American ancestry, and/or obesity are at risk for PCOS and deserve close surveillance. The laboratory evaluation of the adolescent with suspected PCOS or hyperandrogenism should be individualized based on the history, symptoms, and examination findings. The cornerstone of management of PCOS in adolescence includes either a combination oral contraceptive or progestin. Consideration of insulin-sensitizing agents, antiandrogens, topical treatments for acne, and various treatments for hair removal are dependent on the patient's symptoms and concerns. Healthy eating, regular exercise, and for the overweight adolescent, weight reduction, are encouraged to reduce the risk of cardiovascular disease and type II diabetes mellitus. Numerous studies have shown that weight loss and exercise decrease androgen levels, improve insulin sensitivity, and lead to the resumption of ovulation. Although initial studies suggest that Metformin may be particularly useful for treating the PCOS adolescent with insulin resistance and obesity, additional studies are needed to determine the efficacy and long-term outcome. Management of the adolescent with PCOS is challenging and requires a supportive, multidisciplinary team approach for optimal results.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Polycystic Ovary Syndrome in Adolescence

Driscoll

2003

Annals of the New York Academy of Sciences

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“…Advance provision of emergency contraception increases the likelihood of use in the event of unprotected intercourse, without increasing sexual risk behavior. 73–75 Additional guidance on contraceptive method selection and usage can be found through the US Medical Eligibility Criteria for Contraceptive Use http://www.cdc.gov/reproductivehealth/unintendedpregnancy/usmec.htm, as well as the US Selected Practice Recommendations (US SPR) for Contraceptive Use http://www.cdc.gov/reproductivehealth/unintendedpregnancy/usspr.htm.…”

Section: Family Planningmentioning

confidence: 99%