Effective treatment of different types of polycystic ovary syndrome in adolescent girls

Author:

Uvarova E. V.1ORCID,Khashchenko E. P.2ORCID,Kyurdzidi S. O.1ORCID

Affiliation:

1. Sechenov First Moscow State Medical University (Sechenov University); Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology

2. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology

Abstract

This review is addressing an urgent problem of diagnosis and treatment strategy of polycystic ovary syndrome in adolescent girls. We analysed data from modern literary publications on the epidemiology and classification of the disease, as well as the adaptation of general principles for the management of young female patients tailored to their age peculiarities. The effective treatment strategies for adolescent girls with PCOS depending on its type are presented. Today there are several contradictions associated with both the diagnosis and treatment of the disease in the medical community. Thus, the use of the well-known Rotterdam criteria makes it difficult to diagnose PCOS in adolescent girls, since the criteria do not take into account characteristic changes that occur during puberty. Such manifestations as acne, hirsutism, menstrual irregularities, high androgen levels and morphology of polycystic ovaries on pelvic ultrasound imaging should be assessed with due account for age, puberty, hormonal balance with an assessment of the ratio of LH (luteinizing hormone)/FSH (follicle-stimulating hormone) and Free Androgen Index. There is no consensus in the medical community regarding the treatment strategy for PCOS. International communities have identified two main goals in the management of patients: normalization of menstrual function and improvement of the patients’ quality of life by preventing clinical symptoms of hyperandrogenism, and metabolic disorders of hyperplastic processes in target organs.Our analysis of objective scientific data showed that modern monophasic combined oral contraceptives (COCs) supplemented by of a folate component should be used to treat young female patients with PCOS, hyperandrogenism and psychosomatic disorders.

Publisher

Remedium, Ltd.

Subject

General Medicine

Reference16 articles.

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2. Goodman N.F., Cobin R.H., Futterweit W., Glueck J.S., Legro R.S., Carmina E. et al. American association of clinical endocrinologists, American college of endocrinology, and androgen excess and pcos society disease state clinical review: Guide to the best practices in the evaluation and treatment of polycystic ovary syndrome – Part 1. Endocr Pract. 2015;21(11):1291–1300. https://doi.org/10.4158/EP15748.DSC.

3. American College of Obstetricians and Gynecologists’ Committee. ACOG Practice Bulletin No. 194: Polycystic Ovary Syndrome. Obstet Gynecol. 2018;131(6):e157–e171. https://doi.org/10.1097/AOG.0000000000002656.

4. Fauser B.C.J.M., Tarlatzis B.C., Rebar R.W., Legro R.S., Balen A.H., Lobo R. et al. Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): The Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril. 2012;97(1):28-38.е25. https://doi.org/10.1016/j.fertnstert.2011.09.024.

5. Uvarova E.V. Pediatric and adolescent gynecology: a guide for physicians. M.: Litterra; 2009. 384 p. (In Russ.) Available at: https://www.rosmedlib.ru/book/ISBN9785904090036.html.

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