PCOS diagnosis in adolescents: the timeline of a controversy in a systematic review
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Helen Vassalou
Abstract
Study objective
Polycystic ovary syndrome (PCOS) in adolescence, a disorder of exclusion, has proved to be a timeless diagnostic challenge for the clinician. Since 1990, several attempts to provide clear diagnostic criteria have been published, most of the time leading to inconsistencies. We attempted to elucidate the controversies and convergences of this subject by conducting a systematic review of the literature concerning official guidelines or proposed criteria for the diagnosis of PCOS in adolescent girls.
Design
Based on a term search sequence via electronic databases such as Pubmed, Cochrane, Embase, Scopus and a hands-on review of references and learned societies, all available data were classified and analyzed. Single case reports, original studies with adult population or articles with incomplete diagnostic guidelines were excluded.
Results
Twelve reports dated from 2006 to 2018 fulfilled the inclusion criteria. Seven of them were endorsed or published by learned societies. All suggested a stricter diagnosis than in adulthood. Polycystic ovarian morphology was used as a necessary criterion only in three guidelines, and there was a tendency for a more objective diagnosis of hyperandrogenism, defined either by clinical features or by biochemical hyperandrogenemia, although in one case both were required.
Conclusion
Irregular menstrual cycles, allowing for an interval of at least 2 years postmenarche, and hyperandrogenism, usually reinforced by biochemical confirmation, are the main accepted features for PCOS diagnosis in adolescence. Discrepancies among endocrine and reproductive medicine societies still remain, although recent intensified attempts at reaching a consensus should allow for more universally accepted diagnostic criteria.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Conflict of interests: The authors received no funding for this study and have no conflict of interest to disclose.
Ethical statement: This work did not involve human subjects and did not require a formal Ethical Institutional Review.
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Supplementary Material
The online version of this article offers supplementary material (https://doi.org/10.1515/jpem-2019-0024).
©2019 Walter de Gruyter GmbH, Berlin/Boston
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Articles in the same Issue
- Frontmatter
- Review
- PCOS diagnosis in adolescents: the timeline of a controversy in a systematic review
- Original Articles
- Association between mild hyperthyrotropinemia and hypercholesterolemia in children with severe obesity
- Self-rated Tanner stage and subjective measures of puberty are associated with longitudinal gonadal hormone changes
- Early puberty in end stage renal failure and renal transplant recipients
- Present status of prophylactic thyroidectomy in pediatric multiple endocrine neoplasia 2: a nationwide survey in Japan 1997–2017
- Evolution of circulating thyroid hormone levels in preterm infants during the first week of life: perinatal influences and impact on neurodevelopment
- Wolcott-Rallison syndrome in Iran: a common cause of neonatal diabetes
- Etiology of primary adrenal insufficiency in children: a 29-year single-center experience
- The European Phenylketonuria Guidelines and the challenges on management practices in Portugal
- Case Reports
- Transient neonatal hypothyroidism following a short course of maternal amiodarone therapy
- A series of three case reports in patients with phenylketonuria performing regular exercise: first steps in dietary adjustment
- Utilization of a shared decision-making tool in a female infant with congenital adrenal hyperplasia and genital ambiguity
- Experience of intravenous calcium treatment and long-term responses to treatment in a patient with hereditary vitamin D-resistant rickets resulting from a novel mutation
