Treatment of the adolescent patient with polycystic ovary syndrome

Frequently, a multidisciplinary approach is needed in the management of the adolescent with PCOS. Treatment must be provided in a supportive environment. Because adolescent females are concerned about their appearance any image, short-term treatment goals are usually directed toward the amelioration of hirsutism, acne, and irregular menstruation. Although not immediately concerning to the adolescent, the prevention of long-term sequelae from anovulation and hyperinsulinemia is also important. Multiple concomitant therapies are often necessary to address the variety of symptoms and achieve better results. Recent studies have investigated the role of the insulin-sensitizing agent, metformin, in the treatment of PCOS. Although most studies show a benefit, the conclusions are limited owing to the small numbers of select patients, observational designs, and short durations of follow-up. In addition, there are few data comparing insulin-sensitizing drugs with traditional therapies for PCOS. More long-term, randomized controlled trials are needed to determine the utility of insulin-sensitizing agents, their long-term benefits, and the ideal patient population for their use.