Update on diagnosis of polycystic ovary syndrome during adolescence.
Level 5 - mechanism / opinion, no new human data
Narrative review synthesizing diagnostic criteria and recent literature without systematic review methodology.
PubMed 40945763 · doi:10.1016/j.fertnstert.2025.09.006
What was done
This narrative review evaluated literature published from August 2022 to May 2025 concerning the diagnosis of polycystic ovary syndrome (PCOS) during adolescence, in the context of the 2023 international evidence-based guideline update.
What was found
The abstract reports no numerical data or effect sizes. It details that diagnosing PCOS in adolescents requires two criteria: irregular menstrual cycles (defined relative to time post-menarche) and hyperandrogenism (clinical or biochemical), after excluding other causes. Polycystic ovarian morphology on pelvic ultrasound and serum anti-müllerian hormone (AMH) levels are excluded from diagnostic criteria in this age group. Individuals meeting only one criterion are classified as "at risk" and require metabolic monitoring.
Why it matters
Applying adult diagnostic criteria to adolescents leads to misdiagnosis, as multifollicular ovarian morphology and transient cycle irregularities are common during normal pubertal maturation. These refined criteria standardise pediatric practice and prevent overdiagnosis.
Limits
The paper is a narrative review rather than a systematic review; search strategies, study screening methods, risk-of-bias assessments, and the total number of reviewed studies are not reported in the abstract. Diagnostic accuracy metrics (such as sensitivity, specificity, or predictive values) for the proposed thresholds are not provided.