PCOS: Perspectives from a Pediatric Endocrinologist and a Pediatric Gynecologist

The document from 2013 provides insights into the diagnosis and treatment of Polycystic Ovary Syndrome (PCOS) in adolescents from the perspectives of a pediatric endocrinologist and a pediatric gynecologist. It notes that PCOS affects 4-12% of women of reproductive age and can lead to various health issues, including endometrial pathology, obesity, insulin resistance, and hyperandrogenemia. The prevalence among adolescents is around 3% based on an Iranian study. The disorder's pathogenesis is linked to genetic factors and disruptions in the hypothalamic-pituitary-gonadal axis. Clinically, PCOS presents with menstrual abnormalities and signs of hyperandrogenemia, such as hirsutism, acne, and alopecia. The document emphasizes the importance of accurate diagnosis, which relies on the presence of hyperandrogenism, chronic anovulation, and polycystic ovaries, and suggests that laboratory evaluation is crucial despite the absence of a definitive endocrine marker. Treatment focuses on managing symptoms and preventing comorbid conditions, with low-dose combination oral contraceptive pills (COCs) being effective for menstrual regulation and antiandrogen therapy for hirsutism. Lifestyle interventions are recommended for obesity management, and insulin-sensitizing agents may be used for insulin resistance. The document highlights the need for individualized care and the importance of early treatment to mitigate long-term health consequences.