Polycycstic Ovarian Syndrome (PCOS) in adolescents: a literature review

Abstract

PCOS is a common endocrine disorder in women of reproductive age, with a prevalence of 5-18%. In adolescents, prevalence rates are lower, with studies indicating rates of 0.8% in the United States and 3% in Iran. The condition is characterized by clinical hyperandrogenism, menstrual irregularities, and polycystic ovarian morphology. The development of PCOS is influenced by multiple factors, including genetic predisposition, insulin resistance, obesity, and hormonal imbalances. Increased luteinizing hormone (LH) and insulin resistance drive excess androgen production in the ovaries. Insulin enhances the effects of LH, contributing to hyperandrogenism and anovulation. Obesity exacerbates symptoms by increasing androgen production and worsening insulin resistance. PCOS is diagnosed based on clinical, biochemical, and ultrasound findings. Hyperandrogenism is evaluated by measuring testosterone levels, and polycystic ovarian morphology is assessed via ultrasound. Imaging studies such as transvaginal ultrasound and MRI may be used when clinical findings are unclear. Management strategies include lifestyle modification, pharmacological therapies, and cosmetic treatments. Lifestyle changes, including diet and exercise, are first-line therapies. Oral contraceptives, antiandrogens, and metformin are commonly used to control symptoms. The goal is to improve quality of life and prevent long-term complications such as metabolic syndrome and type 2 diabetes. PCOS in adolescents requires individualized management to address both immediate symptoms and long-term health risks. Early intervention can improve outcomes and prevent complications associated with the syndrome.