Endocrine Abstracts

JOINT621

Background: Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder in adolescents, marked by menstrual irregularities, hyperandrogenism, and metabolic dysfunction. Early diagnosis and tailored treatments are essential to mitigate long-term risks such as infertility and diabetes. This review evaluates the effectiveness of lifestyle, pharmacological, and combination therapies in managing adolescent PCOS.

Objective: This study reviews treatment options and outcomes for adolescents with PCOS from 1990 to 2024, focusing on the efficacy of lifestyle interventions, pharmacological treatments, and combination therapies. Success rates, number of studies, and patient data were analysed for each treatment type.

Methods: Fifteen studies involving 1,062 adolescent patients were reviewed. Data were synthesized into three categories of therapy, with outcome success rates and patient improvements evaluated.

Results: • Lifestyle Modifications: Six studies, including 450 adolescents, demonstrated that diet and exercise significantly improved metabolic and reproductive outcomes, with 65%-80% success rates in reducing insulin resistance and improving ovulation. Weight reduction was particularly effective in obese patients, contributing to better glucose tolerance and reduced androgen levels. These foundational interventions are critical for long-term metabolic health.

• Pharmacological Treatments: Ten studies with 612 patients highlighted the efficacy of medications like metformin and oral contraceptives (OCs). Metformin showed success in normalizing glucose tolerance in 66.7% of cases and improving insulin sensitivity in 80%. OCs were effective in regulating menstrual cycles and reducing androgenic symptoms, with response rates between 60%-77.8%. Antiandrogens also showed promising results in managing hirsutism and acne, though specific response rates were not uniformly reported. Pharmacological therapies are essential for addressing hormonal imbalances and metabolic dysfunctions.

• Combination Therapies: Five studies comprising 230 patients reported the highest success rates (70%-80%) for combined approaches. Therapies such as lifestyle changes paired with metformin or OCs showed substantial improvements in ovulation, menstrual regularity, and insulin sensitivity. Myo-inositol combined with alpha-lipoic acid reduced insulin resistance by 65%. These findings underscore the synergistic benefits of integrating lifestyle and pharmacological interventions.

Conclusions: Combination therapies achieve the highest success rates in managing PCOS in adolescents, while lifestyle modifications remain foundational. Pharmacological treatments, particularly metformin and OCs, effectively address hormonal and metabolic dysfunction. This review emphasizes the importance of individualized, early interventions to optimize outcomes. Further research should focus on the long-term efficacy of these treatments and emerging therapeutic options.

Recommendations: • Tailored combination therapies with lifestyle modifications and pharmacological treatments improve outcomes in adolescents with PCOS.

• Long-term studies are needed to assess treatment durability and explore novel interventions.