ABSTRACT
Despite being the most common endocrine disorder in women, controversy continues regarding the underlying etiopathogenesis, diagnostic criteria, and recommendations for polycystic ovary syndrome (PCOS) in adolescents. Recent literature has recognized these deficiencies and evidence based expert recommendations have become more available. Given the current level of evidence, a definitive diagnosis of PCOS is not necessary to effectively identify and treat manifestations of this syndrome in adolescents. Deferring a diagnosis, while providing symptom treatment and regular follow-up of symptomology, is a recommended option. Although the presence of polycystic ovarian morphology (PCOM) is a key diagnostic criterion of PCOS in adults, it is not recommended, at present, in the diagnostic evaluation of PCOS in adolescents. As such, the diagnosis of PCOS in adolescents currently hinges on evidence of ovulatory dysfunction and androgen excess. PCOS is associated with long- term health risks that can impact almost every aspect of the adolescent and young woman's life. Metabolic, oncologic, reproductive, sleep, and psychiatric sequela have been reported. Treatment options for PCOS should be individualized to the presentation, needs, and preferences of each patient. Goals of treatment are to improve quality of life and long-term health outcomes. Clinicians should be mindful of the significant associated psychological morbidity and effectively screen and manage these conditions in adolescents with manifestations of PCOS.
