Managing adolescent PCOD is difficult due to the high prevalence of metabolic complications

Polycystic Ovary Syndrome (PCOS) is a prevalent hormonal disorder affecting 5-10% of women globally, marked by irregular menstrual cycles and ovarian cysts. An early diagnosis and treatmentcan help prevent complications like diabetes and heart disease in these women. PCOS affects various aspects of health, including reproductive, cosmetic, metabolic, and psychological areas. 

A recent study investigated the diagnosis and treatment methods for managing adolescent PCOS in Bangladesh.

This study was undertaken at the Holly Lab Hospital & Missionary Hospital in Brahmanbaria, Bangladesh and spanned about a year(January to December 2023). The PCOS diagnoses were based on clinical and biochemical signs of hyperandrogenism and persistent menstrual irregularities. The study included females aged 10-19 years, those without specific medical conditions or ongoing treatments. Comprehensive medical information was gathered through interviews. Statistical analyses were performed using SPSS, with logistic regression identifying metabolic syndrome risk factors.

Overall, 107 adolescents with PCOS were selected – with the majority aged 10-15 years (55.14%); average age - 16.8 years. BMI analyses of the participants indicated a high prevalence of overweight (29.70%) and obesity (39.40%). Abdominal obesity was detected in 76.60%, while 20% were pre-hypertensive, and 3.40% had HTN. Glycemic status assessment revealed that 76% were normoglycemic, 21.10% prediabetic, and 2.90% diabetic. Additionally, dyslipidemia was present in 90.90% and metabolic syndrome in 42.30%. Biochemical hyperandrogenism was found in 33.70%. PCOS features included hirsutism (94.90%) and oligomenorrhea (87.85%). Further, these women exhibited diverse ovarian morphology patterns. Of note, the key contributors to PCOS diagnosis were hyperandrogenism, ovulatory dysfunction, ovarian morphology, and metabolic factors. Treatment approaches varied _ classical interventions (34.58%), lifestyle changes (14.95%), combined oral contraception (12.15%), and anti-androgens (7.48%). Additional treatments included N-acetylcysteine, inositol, vitamin D, and chromium supplementation.

It was concluded that managing adolescent PCOS is challenging due to the high prevalence of metabolic complications. Diagnostic complexity requires careful evaluation to avoid premature labeling and psychological stress. Treatment involves lifestyle interventions, hormonal contraceptives, and anti-androgen medications. For this, standardized diagnostic criteria and a multidisciplinary approach are essential. Early intervention and continuous monitoring are crucial to reduce long-term health risks. Further research on PCOS in diverse populations is recommended for tailored interventions and a deeper understanding.

Source: Akhter F, Siddiqua A. SchInt J ObstetGynec. 2024;7(2):64-9.