Adolescent polycystic ovary syndrome due to functional ovarian hyperandrogenism persists into adulthood.

Abstract

BACKGROUND:

Menstrual irregularity and above-average testosterone levels in adolescence may presage polycystic ovary syndrome (PCOS) in adulthood but persist in only a minority. Prolonged anovulatory cycles in normal adolescents are associated with increased testosterone levels. Thus, questions have been raised about the accuracy of PCOS diagnosed in adolescents.

OBJECTIVE:

The purpose of this study was to follow-up hyperandrogenic adolescents with features of PCOS to test the hypothesis that adolescent functional ovarian hyperandrogenism (FOH) persists into adulthood.

STUDY SUBJECTS:

A series of adults previously reported to have adolescent PCOS, with most documented to have FOH by GnRH agonist or dexamethasone androgen-suppression test criteria, were recalled.

METHODS:

Recall occurred >3 years after the initial diagnosis and at the age of >18.0 years. Respondents underwent examination, baseline androgen evaluation, and an oral glucose tolerance test after discontinuing oral contraceptive therapy.

RESULTS:

Of the adolescent hyperandrogenic patients, 68% (15 of 22) were traceable, and 60% of those traced returned for follow-up, including half (n = 8) of the original FOH group. The baseline characteristics of respondents and nonrespondents were not significantly different. Patients with FOH were reevaluated when their mean age was 23.0 years (range, 18.4-29.4 years), gynecologic age was 10.7 years (range, 5.5-18.4 years), and body mass index was 42.3 kg/m(2) (range, 28.3-52.1 kg/m(2); P = .02 vs adolescence). Serum free testosterone was 24 pg/mL (range, 10-38 pg/mL, normal, 3-9 pg/mL; not significant vs adolescence); all were oligomenorrheic. Whereas 3 of 8 had impaired glucose tolerance as adolescents, at follow-up 6 of 8 had developed abnormal glucose tolerance (2 with type 2 diabetes mellitus).

CONCLUSIONS:

Adolescents with FOH, which underlies most PCOS, uniformly have persistent hyperandrogenism, and glucose tolerance tends to deteriorate. Testing ovarian androgenic function in hyperandrogenic adolescents may be of prognostic value.

• Authors: Robert L Rosenfield, David A Ehrmann, Elizabeth E Littlejohn
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 100 Issue 4 Pg. 1537-43 (Apr 2015) ISSN: 1945-7197 [Electronic] United States
• PMID: 25675386 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)

Chemical References

• Testosterone

Topics

• Adolescent
• Adult
• Age of Onset
• Child
• Female
• Follow-Up Studies
• Glucose Tolerance Test
• Humans
• Hyperandrogenism (blood, complications, epidemiology)
• Menstruation Disturbances (blood, epidemiology, etiology)
• Ovarian Diseases (blood, complications, epidemiology)
• Polycystic Ovary Syndrome (blood, epidemiology, etiology)
• Testosterone (blood)
• Young Adult