Difficulties in diagnosing polycystic ovarian syndrome in adolescents: a narrative review

Sum-Yee CHAN; Victor WT CHAN

doi:10.12809/hkjgom.22.1.05

Authors

Sum-Yee CHAN
Victor WT CHAN

DOI:

https://doi.org/10.12809/hkjgom.22.1.05

Keywords:

Adolescent, Polycystic ovarian syndrome

Abstract

We review the diagnostic criteria of polycystic ovarian syndrome (PCOS) in adolescents. It is important to recognise PCOS early for timely management. Clinicians should be aware of the difficulties in diagnosing PCOS in adolescents. A multi-disciplinary approach for diagnosis and treatment is suggested. For high-risk cases, re-evaluation may avoid under-diagnosing or over-diagnosing PCOS.

References

Fauser BC, Tarlatzis BC, Rebar RW, et al. Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril 2012;97:28-38.e25.

Bozdag G, Mumusoglu S, Zengin D, Karabulut E, Yildiz BO. The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod 2016;31:2841-55.

March WA, Moore VM, Willson KJ, Phillips DI, Norman RJ, Davies MJ. The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria. Hum Reprod 2010;25:544-51.

Franks S. Polycystic ovary syndrome in adolescents. Int J Obes (Lond) 2008;32:1035-41.

Carmina E, Oberfield SE, Lobo RA. The diagnosis of polycystic ovary syndrome in adolescents. Am J Obstet Gynecol 2010;203:201.e1-201.e2015.

World Health Organization. Adolescent Health. Available from https://www.who.int/southeastasia/health-topics/adolescent-health. Accessed 14 July 2020.

Zawadzki J, Dunaif A. Diagnostic Criteria for Polycystic Ovary Syndrome: Towards a Rational Approach. In: Polycystic Ovary Syndrome. Dunaif A, Givens HR, Haseltine FP, Merriam GR, editors. Boston, MA: Blackwell Scientific; 1992: 377-84.

Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod 2004;19:41-7.

Azziz R, Carmina E, Dewailly D, et al. Positions statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. J Clin Endocrinol Metab 2006;91:4237-45.

Legro RS, Arslanian SA, Ehrmann DA, et al. Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2013;98:4565-92.

Witchel SF, Oberfield S, Rosenfield RL, et al. The diagnosis of polycystic ovary syndrome during adolescence. Horm Res Paediatr 2015.

International evidence-based guideline for the assessment and management of polycystic ovary syndrome 2018. Available from: https://www.monash.edu/_data/assests/pdf_file/PCOS_Evidence-Based-Guidelines_20181009-1.pdf.

Metcalf MG, Skidmore DS, Lowry GF, Mackenzie JA. Incidence of ovulation in the years after the menarche. J Endocrinol 1983;97:213-9.

Essah PA, Wickham EP 3rd, Nunley JR, Nestler JE. Dermatology of androgen-related disorders. Clin Dermatol 2006;24:289-98.

Futterweit W, Dunaif A, Yeh HC, Kingsley P. The prevalence of hyperandrogenism in 109 consecutive female patients with diffuse alopecia. J Am Acad Dermatol 1988;19:831-6.

Merino PM, Codner E, Cassorla F. A rational approach to the diagnosis of polycystic ovarian syndrome during adolescence. Arq Bras Endocrinol Metabol 2011;55:590-8.

Lizneva D, Gavrilova-Jordan L, Walker W, Azziz R. Androgen excess: investigations and management. Best Pract Res Clin Obstet Gynaecol 2016;37:98-118.

Eichenfield LF, Krakowski AC, Piggott C, et al. Evidence-based recommendations for the diagnosis and treatment of pediatric acne. Pediatrics 2013;131(Suppl 3):S163-S186.

Yildiz BO, Bolour S, Woods K, Moore A, Azziz R. Visually scoring hirsutism. Hum Reprod Update 2010;16:51-64.

Wild RA, Vesely S, Beebe L, Whitsett T, Owen W. Ferriman Gallwey self-scoring I: performance assessment in women with polycystic ovary syndrome. J Clin Endocrinol Metab 2005;90:4112-4.

Jones GL, Hall JM, Balen AH, Ledger WL. Health-related quality of life measurement in women with polycystic ovary syndrome: a systematic review. Hum Reprod Update 2008;14:15-25.

Rosner W, Auchus RJ, Azziz R, Sluss PM, Raff H. Position statement: utility, limitations, and pitfalls in measuring testosterone: an Endocrine Society position statement. J Clin Endocrinol Metab 2007;92:405-13.

van Hooff MH, Voorhorst FJ, Kaptein MB, Hirasing RA, Koppenaal C, Schoemaker J. Insulin, androgen, and gonadotropin concentrations, body mass index, and waist to hip ratio in the first years after menarche in girls with regular menstrual cycles, irregular menstrual cycles, or oligomenorrhea. J Clin Endocrinol Metab 2000;85:1394-400.

Lee TT, Rausch ME. Polycystic ovarian syndrome: role of imaging in diagnosis. Radiographics 2012;32:1643-57.

Codner E, Villarroel C, Eyzaguirre FC, et al. Polycystic ovarian morphology in postmenarchal adolescents. Fertil Steril 2011;95:702-6.e62.

Trapp CM, Oberfield SE. Recommendations for treatment of nonclassic congenital adrenal hyperplasia (NCCAH): an update. Steroids 2012;77:342-6.

Unluhizarci K, Kaltsas G, Kelestimur F. Non polycystic ovary syndrome-related endocrine disorders associated with hirsutism. Eur J Clin Invest 2012;42:86-94.

Committee Opinion No. 714 Summary: obesity in adolescents. Obstet Gynecol 2017;130:660-1.

Dokras A, Witchel SF. Are young adult women with polycystic ovary syndrome slipping through the healthcare cracks? J Clin Endocrinol Metab 2014;99:1583-5.