Management of polycystic ovary syndrome in adolescence

Polycystic ovary syndrome (PCOS) in the adolescent is a frequent cause of menstrual irregularity (mostly persistent oligomenorrhea), acne, hirsutism and even premature pubarche. Typical ultrasound findings in the ovary can complete the clinical diagnosis. The obese especially should also be examined for impairment of insulin sensitivity and glucose tolerance as these, if untreated, may compromise long-term health. The androgen excess of PCOS acts on the pilo-sebaceous unit to cause acne and hirsutism which often have a disturbing psychosocial effect on the teenager. Early detection of the syndrome and its treatment with anti-androgens can save much anguish and for the overweight, loss of weight is an integral part of correct management. The long-term use of metformin for adolescents is still hotly debated but preliminary data suggest it may have a role for symptomatic, and maybe also preventative treatment.