Difficulties in diagnostics of polycystic ovary syndrome in adolescents – a preliminary study

Introduction
Polycystic ovary syndrome (PCOS) accounts for 72–84% of adult hyperandrogenism, and in the majority of cases it begins during puberty. The diagnosis based on the Rotterdam criteria seem not to be efficient enough in adolescents.

Aim of the study
was the analysis of the frequency of PCOS according to Rotterdam criteria in adolescents.

Material and methods
Twenty-six girls with menstrual disorders and/or symptoms of hyperandrogenism two years after menarche were enrolled. We analysed medical history, clinical symptoms, pelvic ultrasound, and testosterone concentration (T).

Results
The study group was divided into three subgroups: with isolated cutaneous manifestation (CM) of hyperandrogenism (n = 6), with isolated menstrual disorders (MD; n = 10), and with cutaneous manifestation and menstrual disorders (CMMD; n = 10). We compared total T (cut-off points: > 42 ng/dl and > 55 ng/dl) and polycystic ovarian morphology (PCOM) occurrence. PCOM was detected in 54% of girls, with the highest proportion in the MD group (70%). Using a testosterone cut-off point of > 42 ng/dl, hyperandrogenaemia was confirmed in 81% with a preponderance of the CMMD group (90%). Eleven patients (42%) met all Rotterdam criteria. By more restrict-ed criteria with a testosterone cut-off point of > 55 ng/dl, hyperandrogenaemia was confirmed in 54% of patients, with the highest con-tribution in the CMMD group (70%), and seven patients (27%) met all Rotterdam criteria. Study did not show any correlation between T and ovarian volume (p = 0.695; R_s= 0.08).

Conclusions
In our study 27% of patients suspected of PCOS met all Rotterdam criteria. The co-occurrence of symptoms increases the probability of hyperandrogenaemia.