Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Department of Diabetes and Vascular Medicine, Monash Health, Melbourne, Australia.
Semin Reprod Med. 2022 Mar;40(1-02):e1-e8. doi: 10.1055/s-0042-1757138. Epub 2022 Sep 12.
Polycystic ovary syndrome (PCOS) is a common, complex, and chronic condition that presents many diagnostic and management challenges for managing clinicians. PCOS diagnosis in adolescents presents a particular challenge for treating clinicians due to the overlap of diagnostic features with normal physiological changes during adolescence. Adolescent diagnostic criteria include well-defined menstrual irregularity according to time postmenarche and hyperandrogenism, but does not require the use of pelvic ultrasound. Adolescents with only one criterion should be considered at risk of PCOS and be followed up around transition to adult care. While PCOS was traditionally considered to be a reproductive disorder, PCOS is now recognized to have major metabolic and cardiovascular health consequences and psychological sequelae that can be present from adolescence. Management of PCOS includes healthy lifestyle, metformin, combined oral contraceptive pill, and/or antiandrogens according to symptoms of concern even in adolescents at risk of PCOS.
多囊卵巢综合征(PCOS)是一种常见、复杂且慢性的疾病,给临床医生的诊断和管理带来了诸多挑战。由于青春期正常的生理变化与诊断特征相重叠,青少年 PCOS 的诊断对治疗医生来说是一个特殊的挑战。青少年的诊断标准包括根据初潮后时间定义明确的月经不规律和高雄激素血症,但不要求使用盆腔超声。只有一个标准的青少年应被视为 PCOS 风险,并在过渡到成人护理时进行随访。虽然 PCOS 传统上被认为是一种生殖障碍,但现在已经认识到它会对代谢和心血管健康产生重大影响,并可能在青春期就出现心理后遗症。即使是有 PCOS 风险的青少年,也应根据关注的症状进行 PCOS 的管理,包括健康的生活方式、二甲双胍、复方口服避孕药和/或抗雄激素治疗。