Hyperandrogenism in Female Adolescents - Conclusions

Key points
- In most cases, hyperandrogenism in adolescence is related to a nascent PCOS.
- Although considered as a benign disease, PCOS may sometimes severely affect the psychological and social behavior of patients.
- Since the laboratory and ultrasonic findings are often not conclusive at this age, the diagnosis may remain presumptive providing other diagnoses have been ruled out and the follow-up does not disclose any atypical evolution.
- First, hirsutism and other clinical manifestations of hyperandrogenism may induce poor self-image, and this is particularly crucial at the time of adolescence.
In most cases, hyperandrogenism in adolescence is related to a nascent PCOS. Since the laboratory and ultrasonic findings are often not conclusive at this age, the diagnosis may remain presumptive providing other diagnoses have been ruled out and the follow-up does not disclose any atypical evolution.
Although considered as a benign disease, PCOS may sometimes severely affect the psychological and social behavior of patients. First, hirsutism and other clinical manifestations of hyperandrogenism may induce poor self-image, and this is particularly crucial at the time of adolescence. Second, anxiety may develop about the fertility prognosis. Lastly, the metabolic long-term risks may threaten some patients excessively. Therefore, when PCOS is diagnosed in an individual adolescent or young woman, the clinician should have a long conversation with her, explaining gently and simply what PCOS means in terms of prognosis for her physical and mental health. The right way is a narrow track, between a guilty silence and anxiogenic medical overactivism.
References
Hyperandrogenism in Adolescent Girls
The Physiological Hyperandrogenism of Puberty
Diagnosis of Hyperandrogenism in Female Adolescents
Causes of Hyperandrogenism in Female Adolescents
Written and revised by
Andrey Nailor, M.D.
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