Pediatria pre prax 2/2026
Polycystic ovary syndrome from an endocrinologist’s perspective
Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders and the most common cause of infertility in women. Polycystic ovary syndrome arises as a result of genetic and environmental factors combined with an unhealthy lifestyle and is typically associated with obesity and insulin resistance. PCOS often begins in adolescence, but due to its heterogenous clinical presentation, which overlap with normal puberty changes, the diagnosis during this stage of life is challenging. An international consortium of experts recently proposed that the term polyendocrine metabolic ovarian syndrome (PMOS) replace PCOS to better reflect the complexity of the syndrome beyond ovarian pathology. The ovarian morphology on ultrasound in adolescence is not specific and is not recommended for the PCOS diagnosis in this age group. The diagnosis is based on the presence of both clinical/biochemical hyperandrogenism (hirsutism, acne, elevated testosterone) and irregular menstrual cycles (defined according to the time post menarche) and following the exclusion of other disorders that mimic PCOS (late onset form of congenital adrenal hyperplasia, androgens secreting ovarian and adrenal tumours etc.). Adolescents with only one of these features – hyperandrogenism or irregular menstrual cycles – can be considered “at risk” of PCOS. Adolescents with PCOS or at risk of PCOS have an increased risk of metabolic syndrome and require regular follow up and screening for complications. Treatment involves lifestyle modifications with an emphasis on a healthy lifestyle, pharmacotherapy with metformin, combined hormonal contraceptives, or antiandrogens as appropriate. Obese patients may benefit from treatment with GLP-1 agonists. From a cosmetic perspective, various hair removal methods are suitable. An important part of treatment is providing of mental health and psychosocial support.
Keywords: PCOS, adolescence, hyperandrogenism, menstrual cycle disorder, insulin resistance
