The diagnosis of polycystic ovary syndrome in adolescents

    Enrico Carmina, Sharon E. Oberfield, Rogerio A. Lobo
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    TLDR Diagnosing PCOS in teenagers is challenging and should use strict criteria to avoid misdiagnosis and unnecessary worry.
    The document from 2010 addresses the difficulties in diagnosing polycystic ovary syndrome (PCOS) in adolescents, noting that the broad criteria used for adults may not be suitable for teenagers due to the transient nature of PCOS features during adolescence. The authors reviewed studies, including one with 73 adolescents, which showed a high prevalence of polycystic ovaries (41%) among those with menstrual irregularities, indicating the need for caution in using ovarian morphology as a sole diagnostic criterion. They recommend using strict criteria, including all elements of the Rotterdam criteria, for diagnosing PCOS in adolescents to prevent misdiagnosis and unnecessary distress. The document suggests that an ovarian volume greater than 10 mL on ultrasound, in conjunction with other criteria, may confirm PCOS in adolescents, but advises against relying solely on ovarian morphology. The authors propose starting treatment for milder forms of PCOS at age 18 and highlight that these forms have lower cardiovascular and metabolic risks. A table with suggested criteria for adolescent PCOS diagnosis is included, aiming to identify those with the classic phenotype while accepting that some cases may be overlooked.
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