Ovary Syndrome In Adolescents Research Articles

Is There a Difference in Hirsutism Score in Adolescents with Polycystic Ovary Syndrome on the Basis of Ethnicity and Race?

BackgroundThe complex correlation between ethnicity and race, clinical hyperandrogenism as signified by hirsutism, and biochemical androgen concentrations in Polycystic Ovary Syndrome (PCOS) is poorly understood. Study ObjectiveThe study aims to define the correlation between ethnicity/race and hirsutism score in patients with PCOS. MethodsWe conducted a retrospective chart review of a total of 251 patients with PCOS at the time of diagnosis. Patients were categorized by their ethnicity and race into five main groups: Asian (n=19, 7.6%), Black or African American (n=11, 4.4%), Hispanic or Latino (n=26, 10.3%), White (n=177, 70.5) and others (n=18, 7.2%). General Linear Model was applied using BlueSky Software. ResultsFor the entire study population, the mean age at diagnosis was (15.6±1.7), the mean body mass index (BMI) was (30.6±9.8), the mean hirsutism score using the modified Ferriman-Gallwey (mFG) score chart was (6.2±3.8), and the mean total testosterone was (40.1±20). The hirsutism score was the highest in Asian population (mean=9.1, p=0.002) and Hispanic or Latino population (mean=7.8, p=0.02) followed by others (mean=7.4, p=0.04) and Black or African American population (mean=7.1, p=0.2) compared to White population (mean=5.4). This correlation remained significant despite accounting for BMI and androgen levels (p<0.001). ConclusionThere are factors likely related to hair follicle sensitivity or endogenous response to circulating free androgens that differ between ethnicities and races, such that similar biochemical concentrations lead to differing severity of hirsutism, despite accounting for differences in BMI and androgen levels. More research is needed in this realm to understand the pathophysiologic basis of this interaction.

Awareness of polycystic ovarian syndrome in adolescents: A cross-sectional study

Awareness of polycystic ovarian syndrome in adolescents: A cross-sectional study

Low-Calorie Ketogenic Diet: Potential Application in the Treatment of Polycystic Ovary Syndrome in Adolescents.

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Hyperandrogenism, hyperinsulinism and insulin resistance (IR) are the main drivers of clinical, metabolic and reproductive phenotypes of PCOS. In adolescence, the cornerstones of PCOS treatment are lifestyle and dietary interventions. In particular, the quality and quantity of carbohydrates introduced with the diet play a crucial role in the benefits of diet on PCOS. Recently, the ketogenic diet (KD) has attracted significant interest for the treatment of IR and for the control of carbohydrate metabolism, which has proven to be beneficial for several dysmetabolic conditions, including PCOS. The goal of the KD is to induce a fasting-like metabolism with production of chetonic bodies. Ketosis is a good regulator of calorie intake and mimics the starvation effect in the body, leading to body weight control and consequent metabolism. Additionally, during ketogenesis, insulin receptor sensitivity is also promoted. We proposed a broad overview of the available literature regarding KD indications and considered its metabolic benefits useful for improving PCOS management. The reported data support that a low-calorie ketogenic diet (LCKD) plays a positive role as a regulator of control weight, IR, glucose and lipid homeostasis and hormonal profile. Unfortunately, the evidence concerning the benefits of the very LCKD in adolescents with PCOS and excessive body weight is still numerically scarce. Further studies are necessary to understand whether these effects are due to weight loss or to the nutritional characteristics of this diet. Considering the long-term consequences of PCOS, it is crucial to detect the prospects of nutritional interventions to protect fertility, starting in adolescence.

The role of metabolic syndrome in the development of polycystic ovary syndrome in adolescence

The review article presents an analysis of the metabolic syndrome problem in children and adolescents, its role in the development of polycystic ovary syndrome (PCOS) in accordance with the latest International guidelines and modern literature. The urgency of the problem lies in the rapid spread of overweight among children in the world and, consequently, the growth of alimentary-dependent pathology. One of the major consequences of weight problems is metabolic syndrome (MS). There are still no clear MS criteria for children and adolescents. IDF suggests using IDF criteria for adults. Priority in the pathogenesis of MS is given to insulin resistance (IR), which is associated with puberty. The problem of IR assessment remains. HOMA-IR and QUICKI methods are not considered reliable tests to determine IR, so the assessment is based on clinical signs (hyperglycemia, dyslipidemia, abdominal obesity, hypertension). Obesity and IR can be predictors of PCOS, which can often be associated with puberty. Pathological signs of the syndrome typical for adults in adolescence may be a manifestation of the physiological course of puberty. Obligative criteria for the diagnosis of PCOS in adolescence are irregular menstruation/oligomenorrhea, proven biochemically and clinically hyperandrogenemia). First-line therapy for PCOS in adolescents with MS is weight loss and dosed exercise, which helps to normalize a hormonal balance. Drug treatment may include insulin-sensitizing drugs (metformin), antiandrogens (spironlactone, flutamide, cyproterone acetate), 5-alpha-reductase inhibitors (finasteride), combined oral contraceptives, inositol. Prevention of overweight, obesity in children can prevent the development of IR and, accordingly, associated MS and PCOS, reproductive health disorders. Prevention measures are aimed at avoiding maternal obesity, gestational diabetes, malnutrition and smoking during pregnancy, promoting breastfeeding and physical activity.

Practical considerations for diagnosis and treatment of polycystic ovary syndrome in adolescence - distilling guidelines into clinical practice.

The diagnostic criteria for polycystic ovary syndrome (PCOS) in adults may overdiagnose PCOS in adolescents. Since 2015, three guidelines have developed adolescent-specific diagnostic criteria and treatment recommendations. In this review, we compare and contrast the recommendations to assist in the practical application to clinical practice. The guidelines agree that hyperandrogenism with menstrual irregularity be diagnostic criteria for PCOS in adolescents yet have slight differences in how to diagnose hyperandrogenism and in the definition of menstrual irregularity. The diagnostic option of 'at risk for PCOS' is recommended for those girls presenting with criteria within 3 years of menarche or with hyperandrogenism without menstrual irregularity, with re-assessment later in adolescence. Lifestyle changes is first line treatment. Treatment with combined oral contraceptives or metformin is suggested, using patient characteristics and preferences to guide decision-making. PCOS is associated with long term reproductive and metabolic complications and will present during adolescence. Yet, diagnostic features may overlap with normal adolescent physiology. The recent guidelines strove to develop criteria to accurately identify girls with PCOS allowing early surveillance and treatment yet avoid overdiagnosis of normal adolescents.

Polycystic Ovarian Syndrome in Adolescents.

Polycystic ovarian syndrome (PCOS)is a metabolic, reproductive, and psychological complex series of disorders that impacts a woman throughout her lifespan. PCOS is a disorder of hormonal imbalance occurring in women of reproductive age. This disorder is characterized byhigh levels of male androgens like testosterone. This can lead tosymptoms like irregular periods, amenorrhea (absence of menstruation), anovulation (absence of ovulation), hirsutism, acne, and obesity. PCOS also causes metabolic impairment. Multiple peripherally arranged immature follicles of about 2-5mm in diameter are present in the ovary. These follicles do not mature due to hormonal imbalances leading to an irregular menstrual cycle.PCOS is a metabolic, reproductive, and psychological complex series of disorders that impacts a woman throughout her lifespan. Polycystic ovarian syndrome is not a fatal or life-threatening disorder as its main complication is infertility. PCOScan be a root cause ofserious medical conditions like obesity, hypertension, type-2 diabetes mellitus due to insulin resistance, endometrial cancers, ovarian cancer, etc. Stress may causethe hormone levels in the pituitary to fluctuate. Since the menstrual cycle is hormone-based, there are apparent irregularities.

Polycystic Ovary Syndrome in Adolescents: Impact of therapy on clinical and analytical profile

Polycystic Ovary Syndrome in Adolescents: Impact of therapy on clinical and analytical profile

Research Progress of Chinese Medicine in the Treatment of Polycystic Ovary Syndrome in Adolescence

Research Progress of Chinese Medicine in the Treatment of Polycystic Ovary Syndrome in Adolescence

Physiological role and diagnostic value of anti-Mullerian hormone in pediatrics

Background. Anti-Mullerian hormone (AMH) has now gained popularity as a marker of ovarian reserve. It is important to determine the place and role of AMH in children. The purpose of this work was to analyze the data of the scientific literature on the role of AMH in pediatric practice. Materials and methods. A review of the literature in PubMed was conducted, limiting itself to articles in English and updating the search in February 2022. The search term was “anti-Mullerian hormone”. A total of 437 manuscripts were found, including 37 review articles. The search was gradually narrowed with filters of clinical trials and systematic reviews to 75 articles. The references of the original and review articles were then checked to ensure a complete review. AMH is responsible for the differentiation of the gonads, provokes the regression of Mullerian ducts in the male fetus, correlates with karyotype, sexual development, levels of luteinizing hormone, follicle-stimulating hormone, and its serum levels reflect the ovarian reserve in women, even in childhood. Serum AMH is high from prenatal life to puberty. In postnatal period, the secretion of AMH by the testes is stimulated by follicle-stimulating hormone and strongly inhibited by androgens. AMH is of clinical value as a marker of testicular tissue in men with differences in sexual development and cryptorchidism, as well as in the assessment of persistent Mullerian duct syndrome. Determination of AMH is useful for assessing the function of the gonads without the need for stimulation tests and guides the etiological diagnosis of childhood male hypogonadism. In women, AMH is used as a prognostic marker of ovarian reserve and fertility. The use of criteria developed for adult women is problematic for adolescent girls, as clinical signs associated with polycystic ovary syndrome are normal phenomena of puberty. AMH can be used as an additional criterion in the diagnosis of polycystic ovary syndrome in adolescents. However, the lack of an international standard for AMH limits comparisons between AMH analyzes. Conclusions. AMH has broad clinical diagnostic utility in pediatrics, but interpretation is often complex and should be made in the context of not only the age and sex, but also the stage of development and puberty of the child. Recognition of the role of AMH beyond the development and maturation of the gonads may lead to new diagnostic and therapeutic applications that will further expand its use in pediatric practice.

Polycystic Ovary Syndrome in Adolescence: From the Cradle to the Grave

Polycystic Ovary Syndrome in Adolescence: From the Cradle to the Grave

Diagnostic value of anti-Mullerian hormone in adolescent girls with polycystic ovary syndrome

Background. Scientific debate continues on the diagnostic criteria for polycystic ovary syndrome in adolescents (PCOS). In adolescents these criteria cause special diagnostic problems due to the fact that the characteristics of normal puberty often coincide with the signs and symptoms of PCOS. There is a need to develop diagnostic criteria for PCOS in adolescents, which could be used in addition to those proposed. A possible additional diagnostic criterion may be the level of anti-Mullerian hormone (AMH). The purpose of the study is to assess the levels of anti-Mullerian hormone in the blood of adolescent girls with polycystic ovary syndrome. Materials and methods. A clinical-anamnestic and laboratory study of 27 adolescent girls (12–18 years) with PCOS was conducted. The comparison group consisted of 25 girls of the same age without gynecological disorders. Determination of AMG was performed in venous serum (Gen II ELISA, Beckman Coulter). Results. The anamnesis of adolescent girls with PCOS was analyzed: intrauterine hypoxia occurred in almost half of adolescents, pathological course of the postnatal period was observed in 25.9%, infectious index was 4.6, hypertensive-hydrocephalic syndrome was found in 23.8%, minimal cerebral dysfunction 28.5%, autonomic disorders— in 47.6%, most of the surveyed girls had average body weight and height, inverted puberty and disharmonious sexual development. The most common symptoms of PCOS in girls were: hypomenstrual syndrome (86.9%), dermopathy (82.6%) and hirsutism (60.8%). The mean AMG in girls with PCOS and in the comparison group was 3.67±1.0 ng/ml (in girls with PCOS 4.8±0.9 and in girls in the comparison group 3.1±0.7 ng/ml, p&lt;0.05). Adolescent girls with form A PCOS had the highest hormone levels— 6.4 [4.8; 6.9] pg/ml, p&lt;0.01, which may indicate a probable diagnostic value of AMG concentration. Conclusions. Adolescent girls with suspected polycystic ovary syndrome should have a complete set of tests to determine the level of anti-Mullerian hormone as an additional marker, especially in the absence of clinical manifestations of hyperandrogenemia.

Modern approaches to the diagnosis and treatment of polycystic ovary syndrome in adolescence

Тhe diagnosis of polycystic ovary syndrome (PCOS) in adolescence still raises many questions. The problem is that the characteristics of normal puberty often coincide with the symptoms of PCOS. The article presents the criteria of a normal menstrual cycle, clinical and laboratory hyperandrogenism. In the diagnosis of the latter, the most informative indicators are the determination of the index of free testosterone and androstenedione, and the assessment of free and total testosterone are relatively low sensitivity. Clinical hyperandrogenism in adolescents includes only severe acne and hirsutism. The level of antimullerian hormone has no independent significance. Irregular menstrual cycles during the first year after menarche represent a normal period of puberty. At the second and third year after menarche , menstrual cycles of less than 21 days and more than 45 days are considered irregular, and from the fourth year – less than 21 days and more than 35 days. From the second year after menarche, menstrual irregularities are considered to be more than 90 days for any cycle. Primary amenorrhea is indicated by the absence of menarche at 15 years, or 3 years after telarche. Ultrasound is not used as a criterion for PCOS in the first 8 years after menarche due to the high frequency of ovarian multifollicularity in adolescence. Therefore, adolescent girls in the presence of menstrual disorders and hyperandrogenism may be diagnosed with «PCOS. Phenotype B» (ultrasound signs are not taken into account). Adolescents who have signs of PCOS but do not meet the diagnostic criteria are at risk for PCOS. The most important stage of PCOS therapy is lifestyle modification, normalization of body weight and metabolic processes. Combined oral contraceptives in adolescents are more often prescribed not for direct purposes (contraception), but as off-label therapy not only at diagnosis, but also in the «risk group», which involves the treatment of irregular menstrual cycles and / or clinical hyperandrogenism. In the absence of the effect of lifestyle changes, proper nutrition to correct metabolic disorders in addition to combined oral contraceptives may be prescribed metformin, inositol and etc.

Polycystic Ovary Syndrome in Adolescence: Challenges in Diagnosis and Management.

Diagnosing polycystic ovary syndrome (PCOS) during adolescence is challenging since normal pubertal development overlap typical features of this syndrome. The authors aim to summarize the existing evidence concerning PCOS in adolescence, particularly its diagnostic criteria and therapeutic options. A search throughout medical databases such as PubMed and MedScape was performed. Diagnostic criteria include irregular menstrual cycles according to time postmenarche and evidence of clinical hyperandrogenism and/or biochemical hyperandrogenism, provided other causes have been excluded. Polycystic ovarian morphology ought not to be used as a diagnostic criterion. Treatment should target manifestations and/or comorbidities, even in the absence of a definite diagnosis. Lifestyle interventions are the first-line treatment. Combined oral contraceptives, metformin or antiandrogens may also be considered as adjuvants. Screening for PCOS in adolescence is crucial as it allows an early intervention on the symptoms and comorbidities presented leading to better long-term reproductive and metabolic outcomes.

Difficulties in diagnosing polycystic ovarian syndrome in adolescents: a narrative review

Difficulties in diagnosing polycystic ovarian syndrome in adolescents: a narrative review

Prevalence of the different phenotypes of polycystic ovarian syndrome in adolescents and its association to metabolic and cardiovascular risk

Prevalence of the different phenotypes of polycystic ovarian syndrome in adolescents and its association to metabolic and cardiovascular risk

Pancreatic fat relates to fasting insulin and postprandial lipids but not polycystic ovary syndrome in adolescents with obesity.

Adolescents with polycystic ovary syndrome (PCOS) and obesity can have insulin resistance, dysglycemia, and hepatic steatosis. Excess pancreatic fat may disturb insulin secretion and relate to hepatic fat. Associations between pancreatic fat fraction (PFF) and metabolic measures in PCOS were unknown. This secondary analysis included 113 sedentary, nondiabetic adolescent girls (age = 15.4 [1.9] years), with or without PCOS and BMI ≥ 90th percentile. Participants underwent fasting labs, oral glucose tolerance tests, and magnetic resonance imaging for hepatic fat fraction (HFF) and PFF. Groups were categorized by PFF (above or below the median of 2.18%) and compared. Visceral fat and HFF were elevated in individuals with PCOS versus control individuals, but PFF was similar. PFF did not correlate with serum androgens. Higher and lower PFF groups had similar HFF, with no correlation between PFF and HFF, although hepatic steatosis was more common in those with higher PFF (≥5.0% HFF; 60% vs. 36%; p = 0.014). The higher PFF group had higher fasting insulin (p = 0.026), fasting insulin resistance (homeostatic model assessment of insulin resistance, p = 0.032; 1/fasting insulin, p = 0.028), free fatty acids (p = 0.034), and triglycerides (p = 0.004) compared with those with lower PFF. β-Cell function and insulin sensitivity were similar between groups. Neither PCOS status nor androgens related to PFF. However, fasting insulin and postprandial lipids were worse with higher PFF.

Analysis of New Biomarkers for the Diagnosis of Polycystic Ovary Syndrome in Adolescents

Analysis of New Biomarkers for the Diagnosis of Polycystic Ovary Syndrome in Adolescents

Diagnosis and treatment of polycystic ovary syndrome in adolescents: Erratum.

Diagnosis and treatment of polycystic ovary syndrome in adolescents: Erratum.

Diagnosis and treatment of polycystic ovary syndrome in adolescents.

Polycystic ovary syndrome (PCOS), characterized by ovulatory dysfunction and hyperandrogenism, is one of the most common endocrine disorders in women of reproductive age. Early diagnosis can help clinicians address associated long-term metabolic and reproductive health complications and mitigate the negative effects of PCOS on a patient's mental health and quality of life. Clinicians often are challenged by the diagnosis and management of PCOS because of controversies around diagnostic criteria, especially for adolescents. The International Consortium of Paediatric Endocrinology 2017 Consensus Statement provides practical guidance for clinicians to implement best practices for the identification, diagnosis, and management of PCOS in adolescents.

Challenges in diagnosis of polycystic ovary syndrome in adolescence

Objective we evaluated clinical features, the hormonal status, and ovarian morphological characteristics using ultrasound (US) in adolescents with polycystic ovary syndrome (PCOS) and an ‘increased risk’ of PCOS, and compared the data to age-matched controls. Methods the prospective study involved 154 adolescents (≥2 and <8 years post menarche): Group I-adolescents with PCOS (n = 60), Group II- adolescents with an ‘increased risk’ of PCOS (n = 48), and Group III- control group (n = 46). PCOS patients met all 3 diagnostic criteria of the Rotterdam consensus (2003), an ‘increased risk’ of PCOS was accepted as ‘menstrual irregularities and clinical and/or biochemical hyperandrogenism’. Results In adolescents with PCOS and ‘increased risk’ of PCOS, AMH and SHBG did not differ significantly. In Group I and Group II, the average AMH level was significantly higher, while SHBG was significantly lower than in the controls (p < .001). Androgen levels and mFG in Group I and Group II did not differ significantly, but were significantly higher than in controls (p < .001). In Group I, index of insulin resistance and the number of antral follicles (AFC) were significantly higher than in the comparison groups (p < .05). There was no significant difference in ovarian volume between comparison groups (p < .001). Conclusions A combination of AMH, SHBG, clinical and biochemical hyperandrogenism and menstrual irregularities may be considered as diagnostic markers of PCOS in adolescents and for the identification of a ‘risk group’ for developing PCOS. Ultrasound estimation of AFC are a more specific marker of ovarian morphology in adolescents with PCOS, rather than ovary volume.