Editors' ChoicePolycystic Ovary Syndrome

Adolescents Are Not Just Small Adults

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Science Translational Medicine  13 Jul 2011:
Vol. 3, Issue 91, pp. 91ec107
DOI: 10.1126/scitranslmed.3002848

Polycystic ovary syndrome (PCOS) suggests a condition related only to the reproductive system. Yet, PCOS represents a larger health issue that can be associated with a series of long-term health problems for women, including obesity, diabetes, and cardiovascular disease. Given the rising incidence of obesity among the adolescent population, there is a need for data describing how PCOS manifests and is diagnosed in this younger population of women.

Hickey et al. studied a cohort of 244 post-menarchal girls, aged 14 to 16, over a 90-day period, to assess diagnostic markers of PCOS, including menstrual irregularities, clinical and biochemical overproduction of androgens, and ovarian morphology. They then used these findings to compare measures of PCOS in the adolescent population with criteria for diagnosing adult women with PCOS. The authors found a series of substantial differences between adults and adolescents. For instance, irregular menses were frequently observed among the adolescent population. However, unlike adult women there was little correlation of oligoovulation in adolescents with either clinical or biochemical signs of hyperandrogenism. In addition, measures of ovarian morphology indicated another important difference: The adolescent cohort demonstrated a larger mean ovarian volume as compared with adult women.

Hickey and colleagues concluded that the accepted criteria for PCOS for adults may not be an accurate way to approach the diagnosis of adolescents. This study provides important insight into the variability of PCOS and underscores the need to develop biochemical and genomic markers to refine diagnosis among this young patient population.

M. Hickey et al., Clinical, ultrasound and biochemical features of polycystic ovary syndrome in adolescents: implications for diagnosis. Hum. Reprod. 26, 1469–1477 (2011). [Abstract]

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