Polycystic Ovary Syndrome in the Adolescent

Abstract

The typical PCOS phenotype of anovulation, androgen excess, and polycystic ovarian morphology can overlap with normal adolescence, thus making the diagnosis more difficult. Early recognition of adolescents at a risk for PCOS allows for earlier intervention with the potential for improved cardiovascular and metabolic health. Mental health issues and poor quality of life are frequently associated with PCOS in adolescent women and, therefore, should be identified and addressed. As with many issues confronting the adolescent, peer and family support should be encouraged. Lifestyle changes and weight loss should be thought of as first-line therapy for young women with PCOS. Combined hormonal contraceptives remain the medical therapy of choice for the treatment of menstrual irregularity, hirsutism, acne, and contraception. Metformin and spironolactone may be considered, with metformin particularly beneficial in young women with metabolic abnormalities. This review contains 2 tables and  50 references. Key Words: antiandrogens, antimüllerian hormone, hirsutism, hyperandrogenism, hyperinsulinemia, insulin resistance, menstrual irregularity, obesity, oral contraceptive pills, polycystic ovary