Rachmiel M, Kives S, Atenafu E, Hamilton J
Primary amenorrhea as a manifestation of polycystic ovarian syndrome in adolescents: a unique subgroup? [Comparative Study, Journal Article]
Arch Pediatr Adolesc Med 2008 Jun; 162(6):521-5.
OBJECTIVE: To compare clinical and metabolic features of adolescents having primary amenorrhea (PA) and polycystic ovarian syndrome (PCOS) with those having oligomenorrhea or secondary amenorrhea (OM/SA) and PCOS.
DESIGN: Retrospective case-control study.
SETTING: Endocrine Gynecology Clinic at The Hospital for Sick Children, Toronto, Ontario, Canada.
PATIENTS: Girls and young women aged 14 to 18 years having PA and PCOS (n = 9) seen during a 2(1/2)-year period were compared with control subjects having OM/SA and PCOS (n = 18) randomly selected during the same period.
INTERVENTION: Medical record review was performed to assess clinical, biochemical, and ultrasonographic measures, as well as response to a progesterone challenge.
MAIN OUTCOME MEASURES: Differences in response to the progesterone challenge, hyperandrogenism, and the presence of features of the metabolic syndrome.
RESULTS: Compared with adolescents having OM/SA, adolescents having PA demonstrated older age at pubarche, higher androstenedione levels, greater prevalence of family history of obesity, a tendency toward no withdrawal bleeding in response to the progesterone challenge, and more features associated with the metabolic syndrome (acanthosis nigricans, higher diastolic blood pressure, and lower high-density lipoprotein cholesterol level). No significant correlation was demonstrated between response to the progesterone challenge, metabolic features, and androstenedione levels.
CONCLUSION: Adolescents with PA and PCOS exhibit increased features of the metabolic syndrome and higher androstenedione levels and may represent a more severe spectrum of a common condition.
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