Endocrine Abstracts

JOINT619

Objective: To compare the clinical and biochemical presentation of polycystic ovary syndrome (PCOS) in adolescent girls and adult women, focusing on differences in prevalence, age of presentation, symptoms, biochemical data, imaging findings, treatment response, and outcomes.

Methods: This review synthesized data from 18 studies published between 1990 and 2024, involving approximately 1,200 patients. The findings highlight distinct variations in PCOS characteristics and management strategies across these age groups.

Results: Adolescent girls demonstrated a prevalence of 5%-10%, particularly higher in those with obesity, compared to 6%-20% in adult women. Adolescents typically presented during early to mid-puberty with symptoms such as menstrual irregularity, acne, and mild hirsutism, while androgenic alopecia and infertility were rare. Adults commonly presented in late adolescence or early adulthood with more severe hirsutism, infertility, and androgenic alopecia. Biochemically, adolescents had mild hyperandrogenemia, reduced sex hormone-binding globulin, and early signs of insulin resistance, with more severe markers seen in obese subgroups. Adults exhibited pronounced dyslipidemia, insulin resistance, and greater metabolic abnormalities. Imaging findings were inconsistent in adolescents, while adults consistently demonstrated larger ovarian volumes with polycystic morphology. Adolescents responded well to lifestyle modifications, with metformin improving insulin sensitivity and ovulation. In adults, oral contraceptives effectively managed hyperandrogenism and menstrual irregularity, with insulin-sensitizing agents enhancing fertility outcomes.

Discussion: The observed differences in PCOS presentation between adolescents and adults can be attributed to developmental and hormonal factors. In adolescents, the overlap of normal pubertal changes with PCOS symptoms complicates diagnosis, and obesity exacerbates insulin resistance and hyperandrogenism. Conversely, prolonged exposure to hyperandrogenemia and metabolic dysfunction in adults contributes to more severe manifestations, including infertility and endometrial complications. These differences highlight the need for age-specific diagnostic criteria and management strategies. Adolescents show greater plasticity in their metabolic and hormonal systems, making lifestyle interventions particularly effective. Early intervention reduces long-term risks such as type 2 diabetes and cardiovascular disease. Adults often require more aggressive pharmacological interventions to address chronic complications. Understanding these distinctions can guide tailored therapeutic approaches to improve patient outcomes at different life stages.

Recommendations: 1. Early identification and intervention in adolescents can prevent long-term complications of PCOS.

2. Adults require advanced therapies to manage severe symptoms and fertility issues.

Conclusion: Recognizing the differences in PCOS presentation and management between adolescents and adults is essential for effective age-appropriate care, minimizing long-term health risks, and improving quality of life.