An International Consortium Update: Pathophysiology, Diagnosis, and Treatment of Polycystic Ovarian Syndrome in Adolescence

Lourdes Ibáñez, Sharon E. Oberfield, Selma Witchel, Richard J. Auchus, R. Jeffrey Chang, Ethel Codner, Preeti Dabadghao, Feyza Darendeliler, Nancy Samir Elbarbary, Alessandra Gambineri, Cecilia Garcia Rudaz, Kathleen M. Hoeger, Abel López-Bermejo, Ken Ong, Alexia S. Peña, Thomas Reinehr, Nicola Santoro, Manuel Tena-Sempere, Rachel Tao, Bulent O. YildizHaya Alkhayyat, Asma Deeb, DIpesalema Joel, Reiko Horikawa, Francis De Zegher, Peter A. Lee

Research output: Contribution to journalReview article

49 Scopus citations

Abstract

This paper represents an international collaboration of paediatric endocrine and other societies (listed in the Appendix) under the International Consortium of Paediatric Endocrinology (ICPE) aiming to improve worldwide care of adolescent girls with polycystic ovary syndrome (PCOS)1. The manuscript examines pathophysiology and guidelines for the diagnosis and management of PCOS during adolescence. The complex pathophysiology of PCOS involves the interaction of genetic and epigenetic changes, primary ovarian abnormalities, neuroendocrine alterations, and endocrine and metabolic modifiers such as anti-Müllerian hormone, hyperinsulinemia, insulin resistance, adiposity, and adiponectin levels. Appropriate diagnosis of adolescent PCOS should include adequate and careful evaluation of symptoms, such as hirsutism, severe acne, and menstrual irregularities 2 years beyond menarche, and elevated androgen levels. Polycystic ovarian morphology on ultrasound without hyperandrogenism or menstrual irregularities should not be used to diagnose adolescent PCOS. Hyperinsulinemia, insulin resistance, and obesity may be present in adolescents with PCOS, but are not considered to be diagnostic criteria. Treatment of adolescent PCOS should include lifestyle intervention, local therapies, and medications. Insulin sensitizers like metformin and oral contraceptive pills provide short-term benefits on PCOS symptoms. There are limited data on anti-androgens and combined therapies showing additive/synergistic actions for adolescents. Reproductive aspects and transition should be taken into account when managing adolescents.

Original languageEnglish (US)
Pages (from-to)371-395
Number of pages25
JournalHormone Research in Paediatrics
Volume88
Issue number6
DOIs
StatePublished - Dec 1 2017

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All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Ibáñez, L., Oberfield, S. E., Witchel, S., Auchus, R. J., Chang, R. J., Codner, E., Dabadghao, P., Darendeliler, F., Elbarbary, N. S., Gambineri, A., Garcia Rudaz, C., Hoeger, K. M., López-Bermejo, A., Ong, K., Peña, A. S., Reinehr, T., Santoro, N., Tena-Sempere, M., Tao, R., ... Lee, P. A. (2017). An International Consortium Update: Pathophysiology, Diagnosis, and Treatment of Polycystic Ovarian Syndrome in Adolescence. Hormone Research in Paediatrics, 88(6), 371-395. https://doi.org/10.1159/000479371