Diagnosis and Treatment of Polycystic Ovary Syndrome in Teenagers

This article discusses the challenges faced by clinicians in diagnosing polycystic ovary syndrome in adolescent versus adult females. It offers primary care providers the useful knowledge as well as method to diagnosis and treatment of polycystic ovary syndrome in teenagers. The article also talks about the symptoms, diagnosis, and treatment of PCOS. It also highlights the enhanced occurrence of the classic risky elements for cardiovascular disease like dyslipidemia, diabetes, hypertension, fatness and non-classic risky elements like homocysteine, C-reactive protein, as well as tumour necrosis element-?.

Running head: PCOS 0
CLINICAL REPRODUCTIVE ENDOCRINOLOGY
JULY 15, 2019
STUDENT DETAILS:

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PCOS is known as polycystic ovary syndrome. The polycystic ovary syndrome is considered as
very common endocrine disorder in the females. This is related to significant sickness involving
weakened reproductive healthiness, metabolic syndrome, psychosocial dysfunction,
cardiovascular syndrome, as well as enhanced risk of cancer. Disagreement continues regarding
the fundamental etiopathogenesis, diagnostic standards, as well as recommendation for
polycystic ovary syndrome in teenagers. A main purpose of the paper is to offer primary care
providers the useful knowledge as well as method to diagnosis and treatment of polycystic ovary
syndrome in teenagers. In following parts, the challenges faced by clinicians in diagnosing
polycystic ovary syndrome in adolescent versus adult females is discussed and critically
examined.
In recent days, polycystic ovary syndrome is very general issue related to health that may
influence the teen girls as well as young females. This may result in unbalanced menstrual
period, conduct period heavier, or even create period stops.1 This may cause the woman to have
acne as well as hair in excess. The high amount of androgens that take place in polycystic ovary
syndrome may restrict with production and discharge of egg. In a place of maturing eggs,
sometimes cysts grow. At that time, in place of the egg being discharged at a time of ovulation as
in the usual time, cysts make in ovaries. Polycystic ovaries may be expanded. The females with
polycystic ovary syndrome are not ovulating or discharging the egg monthly, so various have
irregular period. The main indicator of polycystic ovary syndrome is missed period of females.
The effects of PCOS on the ovaries can make a girl stop ovulating. However, as this may take up
to two years after the first period for the menstrual phase of female for becoming consistent, this

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can be hard to identify irregular period as the symbol of polycystic ovary syndrome. Still, many
teen-agers with PCOS may have pregnancy in a case when the girls have sex. In this way, when
the females become sexually active, use condom at a time of sex to avoid having pregnancy and
having sexually communicated diseases. In this case, it is significant whether the females have
polycystic ovary syndrome or not.
In present, a criteria utilised to diagnose the conditions of PCOS is similar in females of all
generative age groups that must not be a matter. As teenage signs such as acne, irregular period,
as well as appearance of polycystic ovaries are commonly present in all adolescent women, after
adolescence, this is complex to make the correct diagnosis. It is difficult for the clinicians in
diagnosing PCOS in adolescent versus adult females. Therefore, this would be good to wait for
few years in place of creating the hasty diagnosis of teenagers. Thus, it is required by the doctors
to ensure that the metabolic syndrome must be targeted in screening of the females, who are
supposed to have polycystic ovary syndrome. The polycystic ovary syndrome females have
enhanced risks of establishing psychological changes as well as behavioural changes because of
the long-lasting nature of disorders. This is essential to give appropriate counselling and proper
involvement to the patients of polycystic ovary syndrome. The females, who are depressed
because of sickness of androgenic effects that impend feminine recognition, fatness, and related
poor generative performances. They are various prone to substance abuse as well as smoking.
There is no proper cure of polycystic ovary syndrome. This is regulated only for the treatment of
the symptoms of single patient. There are honest requirements to know and identify these
1References
? Merhi Z, Kandaraki EA, Diamanti-Kandarakis E. Implications and Future Perspectives
of AGEs in PCOS Pathophysiology. Trends in Endocrinology & Metabolism. 2019 Feb 1

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syndromes early to initiate holistic treatment of the syndrome to prevent longer-term illness. The
doctors are required to address endocrine as well as metabolic nonconformities, signifying the
changes in life style and including the utilisation of laser for hirsutism, creates the mainstay of
administration.
The main question is that How Is Polycystic Ovary Syndrome treated. In the case when the
doctor believes that the patients have Polycystic Ovary Syndrome, then the doctor can refer the
patient to the endocrinologist or gynaecologist for the better treatment. The endocrinologist or
gynaecologist would ask the patient in relation to the concern as well as symptom or sign, health
in last few years, health of the members of family, the regular medicines or tablets, any allergies,
as well as various problems. The endocrinologist or gynaecologist would also ask many queries
particularly regarding the period as well as the regularity of the periods. 2 It is considered
as medical past. The doctors would also conduct the physical exams that include following-up
the weight, and seeing for the physical indicators like hair growth, dark skin, and acne. The
doctors may do gynaecologic exams to rule out other possible causes of the signs; however, it is
not always essential for analysis. Sometimes, the doctors ask for blood test to analyse Polycystic
Ovary Syndrome and or to know if signs are caused by different situations, like thyroid or
different ovarian or gland issues. 3 In the addition of this, the doctor may also ask for the pelvic
ultrasound (the secure, painless testing, which uses sound wave to create image of pelvis) for
2 ? Hart R, Doherty DA. The potential implications of a PCOS diagnosis on a woman’s
long-term health using data linkage. The Journal of Clinical Endocrinology & Metabolism.
2015 Mar 1;100(3):911-9
3 Gonzalez F, Considine RV, Abdelhadi OA, Acton AJ. Anti-inflammatory therapy
suppresses proinflammatory cytokine secretion from mononuclear cells and reduces
hyperandrogenism in lean women with polycystic ovary syndrome (PCOS). Fertility and
Sterility. 2016 Sep 1;106(3):e32.

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checking the ovaries for cysts or different issues. Because cysts are not always noticeable, these
tests are not always done. There is no cure for POCSS; however, there are various manners to
make treatment and to manage. The treatment of Polycystic Ovary Syndrome is biggest
challenge for the doctors. In this difficulty, the doctors prescribe diet, exercises, and medicines.4
As per the report of scientific societies, the females with Polycystic Ovary Syndrome present the
enhanced occurrence of the classic risky elements for cardiovascular disease like dyslipidemia,
diabetes, hypertension, fatness and non-classic risky elements like homocysteine, C-reactive
protein, as well as tumour necrosis element-α.50 Polycystic Ovary Syndrome at any stage is
featured through great odds for raised CVD risk markers. Additionally, the raised makers may
take place without fatness however are overstated with fatness. Inappropriately, as with study of
cardiovascular risks, an evaluation of cancer risk in females having PCOS is complex through
existence of various probable confusing elements like T2DM, inflammation, fatness, as well as
metabolic syndrome that are greatly stated in the population having Polycystic Ovary
Syndrome.5
Moreover, the anovulation is very important challenge for generative age females. The most
general endocrinologic cause of this is Polycystic Ovary Syndrome. For that reason, there are
doubts as to whether enhanced endometrial risk of cancer is because of various metabolic risk
4 Rosenfield RL. Letter to the Editor:“Normal Pubertal Development in Daughters of
Women With PCOS: A Controlled Study”. The Journal of Clinical Endocrinology &
Metabolism. 2017 Jul 6;102(7):2560
5 Jacob R, Ramachandran C, Jude C, Venkatachalam U, Rao SK. Peroxisome proliferator
activated receptor gamma polymorphism Pro12Ala in polycystic ovary syndrome
(PCOS) of South Indian Population. Asian Pacific Journal of Reproduction. 2016 May
1;5(3):210-3.

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elements or Polycystic Ovary Syndrome itself that is featured by various metabolic as well as
reproductive problems, which can be liable for the enhanced oncology risks upon endometrium. 6
Additionally, this is very critical for the doctors to assess the strength of the connection because
Polycystic Ovary Syndrome diagnoses utilised in many of the trainings are depended on self-
report or on uncommon measures, as well as, generally, a meaning of Polycystic Ovary
Syndrome has modified over a period with drawbacks also in controlling group. 7Though,
because of the various prejudices as well as because of the heterogeneous nature of Polycystic
Ovary Syndrome, with numerous phenotypes occurrence modifying across life, this is not easy to
develop from present study as to what percentage of females having Polycystic Ovary Syndrome
fall in the risk group. 8
As per the above analysis, it can be concluded that as a symptom as well as sign overlaps from
that of the common population, this would be sensible to wait for at least one year before
detecting polycystic ovary syndrome in girls up to 2 to 3 years post menarche. 9 Even though the
diagnostic criteria for polycystic ovary syndrome have become lesser severe over year,
6 De Leo V, Musacchio MC, Cappelli V, Massaro MG, Morgante G, Petraglia F. Genetic,
hormonal and metabolic aspects of PCOS: an update. Reproductive Biology and
Endocrinology. 2016 Dec;14(1):38.
7 Rosenfield RL, Ehrmann DA. The pathogenesis of polycystic ovary syndrome (PCOS):
the hypothesis of PCOS as functional ovarian hyperandrogenism revisited. Endocrine
reviews. 2016 Jul 26;37(5):467-520.
8 Meyer ML, Sotres-Alvarez D, Steiner A, Cousins L, Talavera GA, Cai J, Daviglus ML,
Loehr LR. Associations of Self-Reported Polycystic Ovary Syndrome (PCOS), Irregular
Menstrual Cycles, and the Metabolic Syndrome in Premenopausal Hispanic/Latina
Women in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).
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140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA: MARY
ANN LIEBERT, INC.

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determination of minimum diagnostic characteristics in adolescents is still the field of
disagreement. It is recommended that advises should be given to these girls in relation to well
lifestyle and regular check-up. 10These advises can be useful for these girls. The most significant
feature will be showing for metabolic syndrome, only as the health check-up as well as
maintaining the records of this level over the period. 11 It is required to give polycystic ovary
syndrome diary to every patient, where they will be able to trace all the elements for minimum
15 years. It is also recommended that in specialized polycystic ovary syndrome clinic, the
clinicians should ensure that all the patient receive sufficient counselling along with right as well
healthy diet along with daily exercise.
9 Russo GT, Pappalardo MA, Giandalia A, Romeo EL, Alibrandi A, Di Bari F, Vita R,
Cucinotta D, Benvenga S. Influence of peroxisome proliferator-activated receptor
(PPAR)-[gamma] exon 2 (Pro12Ala) and exon 6 (His447His) and Gly972Arg insulin
receptor substrate (IRS)-1 polymorphisms on insulin resistance (IR) and beta cell
function in Southern Mediterranean women with polycystic ovary syndrome (PCOS).
In19th European Congress of Endocrinology 2017 May 3 (Vol. 49). BioScientifica.
10 Randeva H. Is cardiovascular risk increased in women with PCOS?-FOR. In19th
European Congress of Endocrinology 2017 May 3 (Vol. 49). BioScientifica.
11 Arentz S, Smith CA, Abbott J, Fahey P, Cheema BS, Bensoussan A. Combined lifestyle and
herbal medicine in overweight women with polycystic ovary syndrome (PCOS): A randomized
controlled trial. Phytotherapy research. 2017 Sep;31(9):1330-40.

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