Polycystic ovarian morphology in postmenarchal adolescents

Codner, Ethel; Villarroel, Claudio; Eyzaguirre, Francisca; López, Patricia; Merino, Paulina M.; Pérez-Bravo, Francisco; Íñiguez, Germán; Cassorla, Fernando

doi:10.1016/j.fertnstert.2010.06.015

Cited by 89 publications

(67 citation statements)

References 28 publications

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“…Some have tried to utilize ultrasound to detect IR. Of note, normoglycemic women often have the phenotypic criteria for polycystic ovaries on ultrasound [54] , consistent with other data in young adolescents showing that poly cystic ovaries by ultrasound appearance often does not correlate with either anovulatory menstrual cycles or me tabolic abnormalities [55] . Therefore ultrasound is too non specific to use with any reliability in measuring IR.…”

Section: Assessment Of Insulin Resistancesupporting

confidence: 86%

Assessing and treating insulin resistance in women with polycystic ovarian syndrome

Traub¹

2011

WJD

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Polycystic ovarian syndrome (PCOS) is a highly pre valent hormonal and metabolic disorder among repro ductive aged women worldwide. Women with PCOS have widely varying phenotypes and seek medical care for differing reasons. In addition to concern for men strual cycle function, ovulation, hirsutism and acne, many PCOS women have abnormal glucose metabolism. While diabetes mellitus and impaired glucose tolerance are easily diagnosed, the diagnosis of and concern for insulin resistance as a precursor disorder is under appreciated. Insulin resistance may be the first im portant marker of metabolic disease in PCOS women at risk for metabolic syndrome and coronary artery di sease.

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Section: Assessment Of Insulin Resistancesupporting

confidence: 86%

Assessing and treating insulin resistance in women with polycystic ovarian syndrome

Traub¹

2011

WJD

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“…At the center of this controversy is the fact that the guidelines used to define PCOM overlap with the criteria for a multifollicular ovary especially when utilizing a transabdominal approach and follicle counts. The ovarian volume starts to increase with the onset of puberty, achieves maximum volume soon after (between menarche and age 16 years), and remains stable or decreases slightly thereafter [82][83][84][85] . Follicle number and size are also noted to increase with puberty, with a higher number of small follicles during adolescence and young adulthood and a decrease thereafter [84] .…”

Section: What Are the Criteria For Pcom In Adolescents?mentioning

confidence: 99%

The Diagnosis of Polycystic Ovary Syndrome during Adolescence

et al. 2015

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dress a series of questions regarding the diagnosis of PCOS during adolescence including the following: clinical and biochemical evidence of hyperandrogenism, criteria for oligoanovulation and polycystic ovary morphology, diagnostic criteria to exclude other causes of hyperandrogenism and amenorrhea, role of insulin resistance, and intervention. Results and Conclusion: Features of PCOS overlap normal pubertal development. Hence, caution should be taken before diagnosing PCOS without longitudinal evaluation. However, treatment may be indicated even in the absence of a definitive diagnosis. While obesity, insulin resistance, and hyperinsulinemia are common findings in adolescents with hyperandrogenism, these features should not be used to diagnose PCOS among adolescent girls. © 2015 S. Karger AG, Basel Key WordsHyperandrogenism · Ovarian hyperandrogenism · Ovary · Polycystic ovary syndrome · Puberty Abstract Background/Aims: The diagnostic criteria for polycystic ovary syndrome (PCOS) in adolescence are controversial, primarily because the diagnostic pathological features used in adult women may be normal pubertal physiological events. Hence, international pediatric and adolescent specialty societies have defined criteria that have sufficient evidence to be used for the diagnosis of PCOS in adolescents. Methods: The literature has been reviewed and evidence graded to ad-

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“…Many adolescents exhibit physiologic menstrual irregularity and signs of androgen excess (e.g., acne) in the peripubertal period (13). In addition, normative testosterone levels are ill defined in this age group (14), and normal adolescent ovarian morphology overlaps with that of women with PCOS (15,16).…”

Section: Diagnostic Criteriamentioning

confidence: 99%

Polycystic ovary syndrome in adolescence: diagnostic and therapeutic strategies

Kamboj

Bonny

2017

Transl. Pediatr

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Controversy continues about the underlying etiopathogenesis, diagnostic criteria, and recommendations for polycystic ovary syndrome (PCOS) in adolescents. Recent literature has recognized these deficiencies and evidence based expert recommendations have become more available. The purpose of this chapter is to offer primary care providers a practical understanding and approach to the diagnosis and treatment of PCOS in adolescents. Although the presence of polycystic ovary morphology (PCOM) is included as a key diagnostic criterion of PCOS in adults, it is currently not recommended for the diagnosis in adolescents. As such, the diagnosis of PCOS in adolescents currently hinges on evidence of ovulatory dysfunction and androgen excess. Recommended evidence of ovulatory dysfunction includes: consecutive menstrual intervals >90 days even in the first year after menstrual onset; menstrual intervals persistently <21 or >45 days 2 or more years after menarche; and lack of menses by 15 years or 2-3 years after breast budding. Recommended evidence of androgen excess include: moderate to severe hirsutism; persistent acne unresponsive to topical therapy; and persistent elevation of serum total and/or free testosterone level. Importantly, a definitive diagnosis of PCOS is not needed to initiate treatment. Treatment may decrease risk of future comorbidity even in the absence of a definitive diagnosis. Deferring diagnosis, while providing symptom treatment and regular/ frequent follow-up of symptomology, is a recommended option.The treatment options for PCOS should be individualized to the presentation, needs, and preferences of each patient. Goals of treatment are to improve quality of life and long-term health outcomes. Lifestyle modifications remain first-line management of overweight and obese adolescents with PCOS. Combined oral contraceptives (COC) are first line pharmacotherapy for management of menstrual irregularity and acne, and metformin is superior to COCs for weight reduction and improved dysglycemia. COCs and metformin have similar effects on hirsutism, but often need to be paired with other treatment modalities to achieve further improvement of cutaneous symptoms. Clinicians should be cognizant that PCOS is associated with significant metabolic and psychological comorbidity and screen for these issues appropriately.

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Polycystic ovarian morphology in postmenarchal adolescents

Cited by 89 publications

References 28 publications

Assessing and treating insulin resistance in women with polycystic ovarian syndrome

Assessing and treating insulin resistance in women with polycystic ovarian syndrome

The Diagnosis of Polycystic Ovary Syndrome during Adolescence

Polycystic ovary syndrome in adolescence: diagnostic and therapeutic strategies

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