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Hum. Reprod. Advance Access published online on March 11, 2004
Human Reproduction, doi:10.1093/humrep/deh207
© 2004 by European Society of Human Reproduction and Embryology
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Debate

Polycystic ovary syndrome in adolescence--a therapeutic conundrum

Roy Homburg 1* and Cornelius B. Lambalk 2

1 Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Vrije Universiteit Medical Centre, De Boelelaan 1117, Postbus 7057, 1007 MB Amsterdam, The Netherlands
2 Division of Reproductive Medicine, Vrije Universiteit Medical Centre, Amsterdam, The Netherlands

* To whom correspondence should be addressed. E-mail: r.homburg{at}vumc.nl.


  Abstract

The polycystic ovary syndrome (PCOS) often presents in adolescence with menstrual disorders, acne and hirsutism. The early diagnostic signs are sometimes dismissed as ‘normal’ changes of adolescence, and the opportunity to save the teenager from the stigmata of the syndrome is missed. The finding that the metabolic syndrome is a possible long-term sequela of PCOS now presents a challenge to make an early diagnosis, educate patients regarding the importance of weight control and exercise, and treat accordingly both symptomatically and prophylactically. The use of long-term insulin sensitizers, particularly metformin, for these purposes in adolescents is now the subject of an inter-disciplinary debate. Good, hard supportive data are not yet forthcoming but, as in the adult, the establishment of metformin treatment for the hyperinsulinaemic adolescent with PCOS may precede the evidence.

Key words: Key words: adolescence/hyperandrogenism/menstrual disturbance/metformin/PCOS


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