The Polycystic Ovary Syndrome: Challenges and Opportunities in Adolescent Medicine

The document from 2009 addresses the complexities of diagnosing and managing Polycystic Ovary Syndrome (PCOS) in adolescents, a condition affecting 5% to 8% of reproductive women characterized by hyperandrogenemia, insulin resistance, and metabolic syndrome. It underscores the importance of early identification and treatment due to the genetic and environmental factors involved in PCOS. The document discusses the challenges of using the NIH and Rotterdam criteria for diagnosis in adolescents and emphasizes the role of hyperandrogenism and obesity in PCOS development. It also explores the genetic basis of the syndrome, the impact of insulin resistance, and the "thrifty" phenotype hypothesis. Management strategies include the use of oral contraceptives and insulin sensitizers like metformin, alongside lifestyle changes. The document concludes that while the polycystic ovary can normalize with lifestyle modifications, the metabolic consequences of PCOS require early intervention to prevent long-term health risks such as diabetes and cardiovascular disease.