Risk factors in adolescence for the development of polycystic ovary syndrome

Abstract

Polycystic ovary syndrome (PCOS) is the most common gynaecological endocrinopathy in women of fertile age and represents a major health issue among women affecting not only reproductive function, but also emergence of the most frequent causes of morbidity and mortality in women of postmenopausal age – type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVDs). The current epidemic of obesity suggests that the prevalence of PCOS and its adverse health effects may rise even further in the future. The ability to predict development of PCOS early in life would be essential to decrease and prevent late morbidity linked to PCOS, although, on the other hand, over-diagnosis should be avoided as it can lead to unnecessary labelling and can impact on an adolescent’s quality of life. Systematic search in the Medline literature database through PubMed using the search terms “Polycystic ovary syndrome”, “PCOS”, “Adolescents”, “Polycystic ovary morphology”, “PCOM”, “Menstrual disorders in adolescence”, “Hirsutism”, “Hyperandrogenaemia”, “Anti-Mullerian hormone”, “Obesity and adolescents” and “Prediction of PCOS”. Follow-up and re-evaluation are warranted in all adolescents with features suggestive of PCOS, such as menstrual irregularities two or more years after menarche, or a menstrual interval >90 days, moderate to severe hirsutism and moderate to severe inflammatory acne vulgaris unresponsive to topical medication. Because of the strong association between obesity, weight gain through life, hyperandrogenism and development of PCOS, screening for PCOS and overweight/obesity as early as in adolescence is important in order to tailor treatment and intervention protocols and reduce future risks of infertility, CVDs and T2DM.