Polycystic Ovary Syndrome in Childhood: Diagnostic and Therapeutic Challenges

    July 2015 in “ NEJM Journal Watch ”
    Mary Wu Chang
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    TLDR Diagnosing and treating PCOS in young people is difficult.
    Eight years ago, a review by Mary Wu Chang, MD, highlighted the challenges in diagnosing and managing Polycystic Ovary Syndrome (PCOS) in children and adolescents. PCOS, an endocrine disorder characterized by oligomenorrhea, hyperandrogenism, and polycystic ovaries, has dermatologic manifestations such as acne, hirsutism, androgenic alopecia, acanthosis nigricans, and seborrheic dermatitis. It is associated with impaired glucose tolerance, obesity, decreased fertility, pregnancy complications, increased risk for endometrial cancer, and possibly cardiovascular complications. Diagnosis requires two of the three Rotterdam criteria: oligoovulation or anovulation, clinical/biochemical signs of hyperandrogenism, and polycystic ovaries on ultrasound. If a suspected diagnosis cannot be confirmed, a provisional PCOS diagnosis should be made to ensure ongoing monitoring and interventions to reduce obesity.
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