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多囊卵巢综合征在青少年中的诊治挑战。

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

机构信息

Department of Ginecology and Obstetrics, Faculty of Medicine, Universidade do Porto, Porto, Portugal.

Department of Gynecology, Unit of Reproductive Medicine, Centro Hospitalar Universitário São João, Porto, Portugal.

出版信息

Rev Bras Ginecol Obstet. 2022 Apr;44(4):425-433. doi: 10.1055/s-0042-1742292. Epub 2022 May 27.

Abstract

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.

摘要

诊断青少年多囊卵巢综合征 (PCOS) 具有挑战性,因为正常的青春期发育与该综合征的典型特征相重叠。作者旨在总结有关青少年 PCOS 的现有证据,特别是其诊断标准和治疗选择。通过对 PubMed 和 MedScape 等医学数据库进行全面检索。诊断标准包括根据初潮后时间的不规则月经周期和临床高雄激素血症和/或生化高雄激素血症的证据,前提是排除了其他原因。多囊卵巢形态不应用作诊断标准。即使没有明确的诊断,也应针对表现和/或合并症进行治疗。生活方式干预是一线治疗。也可以考虑联合口服避孕药、二甲双胍或抗雄激素作为辅助治疗。在青少年中筛查 PCOS 至关重要,因为它可以早期干预出现的症状和合并症,从而获得更好的长期生殖和代谢结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bea3/9948137/50d1175adb7d/10-1055-s-0042-1742292-i210084-1.jpg

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