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An International Consortium Update: Pathophysiology, Diagnosis, and Treatment of Polycystic Ovarian Syndrome in Adolescence
Open accessAbstract
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.
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“However, delineating appropriate diagnostic criteria for PCOS among adolescent girls has been problematic because irregular menses, cystic acne, mild hyperandrogenism, and multifollicular ovarian morphology occur during normal pubertal maturation.”
From Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls (2019) · cites this paper as [126]
In the citing paper
“These similarities between normal pubertal development and the clinical features associated with PCOS confound the diagnosis in adolescent girls (Table 1) [125–127].”
From Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls (2019) · cites this paper as [126]
In the citing paper
“Additional comorbidities can occur in adolescents with PCOS that might be independent of overweight status.”
From Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls (2019) · cites this paper as [126]
In the citing paper
“These comorbidities include impaired glucose tolerance and type 2 diabetes [125, 126, 210, 211].”
From Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls (2019) · cites this paper as [126]
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Metadata
- Authors
- 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., Yildiz, B. O., Alkhayyat, H., Deeb, A., Joel, D., Horikawa, R., de Zegher, F., & Lee, P. A.
- Affiliations
- Hospital Sant Joan de Déu Barcelona (ES)
- Morgan Stanley Children's Hospital (US)
- Children's Hospital of Pittsburgh (US)
- University of Michigan (US)
- University of California San Diego (US)
- Sanjay Gandhi Post Graduate Institute of Medical Sciences (IN)
- Ain Shams University (EG)
- University of Bologna (IT)
- University of Rochester Medicine (US)
- University of Cambridge (GB)
- The University of Adelaide (AU)
- Witten/Herdecke University (DE)
- Yale University (US)
- Mafraq Hospital (AE)
- University of Botswana (BW)
- National Center For Child Health and Development (JP)
- Pennsylvania State University (US)
- ORCID
- Venue
- Hormone Research in Paediatrics
- Publisher
- S. Karger AG
- Published
- 2017
- Volume
- 88
- Issue
- 6
- Pages
- 371-395
- ISSN
- 1663-2818 (ISSN-L)
- 1663-2826
- OpenAlex
- W2770022783
- Semantic Scholar
- 3e6820e26911ea082efdd48cf45057ca2d581ab5
- Cited by
- 463
- References
- 244
- Citations by year
- 2026: 32 · 2025: 46 · 2024: 67 · 2023: 82 · 2022: 65 · 2021: 67 · 2020: 45 · 2019: 40 · 2018: 17
- FWCI
- 32.35
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Hormone Research in Paediatrics (publishedVersion)
- PubMed (publishedVersion)
- Archivio istituzionale della ricerca (Alma Mater Studiorum Università di Bologna) (submittedVersion)
- Archivio Istituzionale della Ricerca - Università degli Studi del Molise (submittedVersion)
- Lirias (submittedVersion)
- Hacettepe University Institutional Repository (hacettepe.edu.tr) (submittedVersion, other-oa)
- Universidad de Chile (submittedVersion, cc-by-nc-nd)
- RISalud Institutional Health Repository of Andalucía (submittedVersion, other-oa)
- Funders
- Medical Research Council (MC_UU_12015/2)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and Kidney Cyst Diseases
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Keywords
- polycystic ovary syndrome, adolescent girls, PCOS pathophysiology, PCOS diagnosis, PCOS treatment, hyperinsulinemia, insulin resistance, anti-Müllerian hormone, hyperandrogenism, menstrual irregularity, hirsutism, obesity, metformin, oral contraceptives, androgen receptor antagonists, lifestyle intervention, reproductive transition, PCOS diagnostic criteria
- MeSH terms
- Adolescent, Congresses as Topic, Female, Humans, Polycystic Ovary Syndrome
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