Polycystic ovary syndrome in adolescents

To highlight the new information in the field of polycystic ovary syndrome (PCOS) in adolescents and how it may pertain to current practice.

The diagnosis of adolescent PCOS remains controversial, and experts continue to debate the appropriate criteria to be used. There is growing support for using Rotterdam criteria, but requiring the presence of all three criteria (oligoovulation or anovulation, hyperandrogenism and polycystic ovaries on pelvic ultrasonography), as the standard 'two of three' criteria may overdiagnose PCOS in adolescents. As adolescent PCOS is better understood, a high rate of metabolic syndrome and sleep disorders is appreciated, which likely has implications on long-term health. The mainstay of PCOS treatment in adolescents should be lifestyle modification (diet, exercise and behavioral changes), and evidence exists that these interventions are beneficial. The use of insulin sensitizers to target PCOS-related insulin resistance and metabolic dysfunction is common, but further studies on its use and effectiveness are warranted.

As a better understanding of adolescent PCOS evolves, including appropriate diagnostic criteria, factors associated with concomitant metabolic disorders and effective treatment options, improved care for these adolescents will be achieved.