Frequency of Polycystic Ovary Syndrome in Adolescents by Diagnostic Criteria

Overview

This study evaluated the prevalence of PCOS in 289 adolescents with hyperandrogenism and/or menstrual disorders using Ibáñez, Peña, and Rotterdam criteria. PCOS prevalence ranged from 46% to 59%, with no significant clinical or hormonal differences between diagnostic groups, but clear differences from non-PCOS patients.

Background

Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting reproductive-aged females, with a global prevalence around 9.2%. Diagnosis in adolescents is challenging due to overlapping physiological changes, leading to the development of specific adolescent criteria such as those by Ibáñez and Peña. The Rotterdam criteria, widely used in adults, may overdiagnose PCOS in adolescents. Understanding PCOS prevalence and clinical profiles in teenagers is crucial for early diagnosis and management.

Data Highlights

Key Findings

• PCOS prevalence in adolescents with hyperandrogenism/menstrual disorders ranged from 46% to 59% depending on diagnostic criteria.
• No significant differences in clinical or hormonal parameters were found between Ibáñez, Peña, and Rotterdam PCOS groups.
• Patients diagnosed with PCOS had significantly higher LH, total testosterone, androstenedione, and ovarian volume compared to non-PCOS patients.
• Oligomenorrhea (>45 days) was the most common menstrual abnormality observed.
• Clinical hyperandrogenism was more prevalent than biochemical hyperandrogenism (88.1%-91.5% vs. 54.9%-55.3%).
• Acne affected approximately 70% of adolescents with PCOS versus less than 40% without PCOS.

Clinical Implications

The high prevalence of PCOS among adolescents highlights the importance of using standardized, age-appropriate diagnostic criteria to avoid over- or under-diagnosis. Recognizing predominant clinical signs such as oligomenorrhea and clinical hyperandrogenism can aid early identification. Early diagnosis enables timely interventions to mitigate long-term metabolic and reproductive complications.

Conclusion

This study underscores the variability in PCOS prevalence depending on diagnostic criteria but confirms consistent hormonal and clinical differences from non-PCOS adolescents. Standardized adolescent-specific diagnostic approaches are essential for accurate diagnosis and management.

References

1. Ibáñez et al. 2017 -- Diagnostic Criteria for PCOS in Adolescents
2. Peña et al. 2020 -- Adolescent PCOS Diagnostic Guidelines
3. Rotterdam Consensus 2003 -- PCOS Diagnostic Criteria