Polycystic Ovary Syndrome in Adolescence

Abstract

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.

Evaluation of insulin resistance in adolescent girl with menstrual irregularities

“…10 Some studies have assessed insulin resistance in adolescents with PCOS. 19,[32][33][34] The gold standard method for the diagnosis of insulin resistance is the hyperinsulinemic euglycemic clamp, a venous glucose tolerance test frequently used in experimental and scientific investigations but still very difficult to perform in clinical practice.…”

“…10 Insulin resistance, Which is related to a post-insulin receptor defect that course with compensatory hyperinsulinemia in addition to other factors such as reduction of hepatic insulin clearance and increased pancreatic sensitivity leading to an abnormal biological response, with increased circulating insulin concentration, is the central pathogenesis of anovulation. 3,[11][12][13][14][15][16] This hyperinsulinemia is responsible for the development of hyperandrogenism that induces anovulation.…”

Hyperandrogenism in adolescents

“…Androjen üreten adrenal tümörlerde ise DHEA-S düzeyi-nin 7000 ng/ml üzerinde olmas› önemlidir. [22] Klinik olarak PKOS düflündüren k›zlarda total testosteron düzeyi normal veya hafif yüksek bulunabilir. Bu olgularda sabah al›nan serumda serbest testosteron art›fl› ve/veya düflük SHBG düzeyi hiperandrojenizmi destekler.…”

Calidad De Vida en Mujeres Con Síndrome De Ovario Poliquístico

“…Los motivos de consulta de las mujeres surgen de esta variedad de manifestaciones (17). Estudios a nivel nacional señalan como primera causa de consulta las alteraciones del ciclo menstrual (18,19), y en grupos de adolescentes aparecen el hirsutismo y acné (20,21).…”