Can analysis of serum androgens aid in the diagnosis of polycystic ovary syndrome (PCOS) in adolescents?

ABSTRACT

Introduction

Polycystic ovary syndrome (PCOS) is a female metabolic disorder that is characterized by ovulatory dysfunction, elevated serum androgen concentrations, and polycystic ovarian morphology (PCOM). However, diagnosis of PCOS in adolescents is challenging.

Areas covered

The mechanisms of PCOS pathophysiology are discussed that include: i) dysregulation of the levels of steroidal enzymes ii) abnormalities in the secretion of gonadotropin releasing hormone, luteinizing hormone, and follicle stimulating hormone , and iii) abnormalities in ovarian Thecal and Granulosa cell function. Current clinical diagnosis protocols for PCOS in women are covered. The challenges in diagnosis of PCOS particularly in adolescents are highlightedWe highlighted an important unmet need for an accurate serum test for the early diagnosis of adolescent girls with PCOS.

Expert opinion

Steroid metabolite profiling that captures hyperandrogenism has shown some early promise to serve as a biomarker for early diagnosis of PCOS in women, something that would be especially useful in adolescents.

KEYWORDS:

• Androgens in women
• hyperandrogenism
• hirsutism
• infertility
• oligoamenorrhea
• polycystic ovarian syndrome
• PCOS

Article highlights

• PCOS is a prevalent metabolic disorder in reproductive age females that affects fertility and is associated with secondary diseases affecting quality of life

• PCOS detection in adolescent age can be leveraged for better management and prevention of comorbidities

• Understanding PCOS pathophysiology is the key to the disease diagnoses

• Several hormones are dysregulated in PCOS, the mechanisms of which need further investigations

• Biochemical mechanistic biomarkers in serum or urine are emerging for PCOS diagnosis

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work was funded by the College of Pharmacy and Pharmaceutical Sciences, Washington State University and the American College of Clinical Pharmacy (ACCP) Foundation Futures Grant Award program.