Diagnosis and treatment of PCOS in adolescents: a summary of guidelines and systematic reviews for practitioners

Polycystic Ovary Syndrome (PCOS) presents unique diagnostic and management challenges in adolescents due to physiologic overlap with normal puberty. This review synthesizes current adolescent-specific guidelines to identify evidence-based diagnostic criteria for adolescent PCOS, to apply first- and second-line management strategies, and to recognize key areas of controversy and unmet need. We emphasize menstrual irregularities and hyperandrogenism as key diagnostic criteria, while noting the limited specificity of polycystic ovarian morphology and anti-Müllerian hormone (AMH) levels in this age group. Management focuses on lifestyle interventions and combined oral contraceptives, with additional pharmacologic options as needed. Individualized monitoring of metabolic risk and psychosocial impact is highlighted. Finally, we propose a research agenda to further explore diagnostic criteria, treatment efficacy, and the long-term metabolic and mental health outcomes in adolescents with PCOS.