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Polycystic ovary syndrome.
Adolesc Med. 1999 Jun; 10(2):321-36.AM

Abstract

Many adolescents present with hirsutism and irregular menses. The challenge for the clinician is to distinguish physiologic anovulatory cycles from true menstrual disorders such as PCOS, and to differentiate PCOS from other causes of hyperandrogenism in hirsute adolescents. Common clinical features seen in adolescents with PCOS include hirsutism, acne, menstrual irregularity, and obesity. Biochemical abnormalities include hyperandrogenism, acyclic estrogen production, LH hypersecretion, decreased levels of SHBG, and hyperinsulinemia. Management strategies for a patient with PCOS include treatment of features which may cause distress to the adolescent, such as hirsutism, acne, and irregular menses, and prevention of long-term sequelae. Oral contraceptive pills, antiandrogens, and cosmetic treatments are used to treat hirsutism, acne, and menstrual irregularity. Oral contraceptive pills or medroxyprogesterone acetate are given to prevent endometrial hyperplasia and carcinoma. Counseling about weight loss and nutrition are essential, as weight loss may improve signs of hyperandrogenism and menstrual irregularity and may prevent NIDDM and cardiovascular disease. Insulin-sensitizing agents show promise in terms of decreasing hyperandrogenism, restoring ovulatory cycles, treating infertility, and preventing long-term sequelae. Finally, it is important to recognize that adolescents with PCOS may experience psychological distress because of the clinical manifestations of hyperandrogenism or when confronted with the information that they have a chronic illness. Psychological support should be available for these young women. Future research is likely to further elucidate the pathophysiology of PCOS, identify candidate genes, and clarify which adolescents are at risk for long-term sequelae. Prospective studies are needed to identify which therapies could potentially reduce the risk of infertility, diabetes, cardiovascular disease, and endometrial carcinoma in young women with PCOS.

Authors+Show Affiliations

Kahn JA
Division of Adolescent/Young Adult Medicine, Children's Hospital, Boston, Massachusetts, USA.
Gordon CM
No affiliation info available

MeSH

AdolescentContraceptives, Oral, HormonalDiagnosis, DifferentialFemaleHirsutismHumansMenstruation DisturbancesMineralocorticoid Receptor AntagonistsPolycystic Ovary Syndrome

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.
Review

Language

eng

PubMed ID

10370713

Citation

Kahn, J A., and C M. Gordon. "Polycystic Ovary Syndrome." Adolescent Medicine (Philadelphia, Pa.), vol. 10, no. 2, 1999, pp. 321-36.
Kahn JA, Gordon CM. Polycystic ovary syndrome. Adolesc Med. 1999;10(2):321-36.
Kahn, J. A., & Gordon, C. M. (1999). Polycystic ovary syndrome. Adolescent Medicine (Philadelphia, Pa.), 10(2), 321-36.
Kahn JA, Gordon CM. Polycystic Ovary Syndrome. Adolesc Med. 1999;10(2):321-36. PubMed PMID: 10370713.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Polycystic ovary syndrome. AU - Kahn,J A, AU - Gordon,C M, PY - 1999/6/17/pubmed PY - 1999/6/17/medline PY - 1999/6/17/entrez SP - 321 EP - 36 JF - Adolescent medicine (Philadelphia, Pa.) JO - Adolesc Med VL - 10 IS - 2 N2 - Many adolescents present with hirsutism and irregular menses. The challenge for the clinician is to distinguish physiologic anovulatory cycles from true menstrual disorders such as PCOS, and to differentiate PCOS from other causes of hyperandrogenism in hirsute adolescents. Common clinical features seen in adolescents with PCOS include hirsutism, acne, menstrual irregularity, and obesity. Biochemical abnormalities include hyperandrogenism, acyclic estrogen production, LH hypersecretion, decreased levels of SHBG, and hyperinsulinemia. Management strategies for a patient with PCOS include treatment of features which may cause distress to the adolescent, such as hirsutism, acne, and irregular menses, and prevention of long-term sequelae. Oral contraceptive pills, antiandrogens, and cosmetic treatments are used to treat hirsutism, acne, and menstrual irregularity. Oral contraceptive pills or medroxyprogesterone acetate are given to prevent endometrial hyperplasia and carcinoma. Counseling about weight loss and nutrition are essential, as weight loss may improve signs of hyperandrogenism and menstrual irregularity and may prevent NIDDM and cardiovascular disease. Insulin-sensitizing agents show promise in terms of decreasing hyperandrogenism, restoring ovulatory cycles, treating infertility, and preventing long-term sequelae. Finally, it is important to recognize that adolescents with PCOS may experience psychological distress because of the clinical manifestations of hyperandrogenism or when confronted with the information that they have a chronic illness. Psychological support should be available for these young women. Future research is likely to further elucidate the pathophysiology of PCOS, identify candidate genes, and clarify which adolescents are at risk for long-term sequelae. Prospective studies are needed to identify which therapies could potentially reduce the risk of infertility, diabetes, cardiovascular disease, and endometrial carcinoma in young women with PCOS. SN - 1041-3499 UR - https://www.unboundmedicine.com/medline/citation/10370713/Polycystic_ovary_syndrome_ L2 - https://medlineplus.gov/polycysticovarysyndrome.html DB - PRIME DP - Unbound Medicine ER -