Prevalence of polycystic ovary syndrome among adolescents depending on the adopted diagnostic criteria

Introduction: PCOS is a common endocrine disorder that impacts hormonal, metabolic, and reproductive health. Its prevalence is steadily increasing, including in the pediatric population, yet there is still a lack of research thoroughly examining the problem of teenage PCOS. Aim: The purpose of the study was to determine the prevalence and clinical-hormonal profile of PCOS among teenage patients with hyperandrogenism and/or menstrual disorders, depending on the adopted diagnostic criteria. Methods: An observational study was conducted on a group of 289 patients referred for diagnosis due to hyperandrogenism and/or menstrual disorders in the years 2019-2022. The study participant were assigned to appropriate groups depending on the diagnostic criteria met (patients with PCOS according to Ibanez, Peña, Rotterdam and patients without PCOS) and descriptive statistics and correlation studies were prepared. Results: The prevalence of polycystic ovary syndrome ranged from approximately 46% to 59%, depending on the diagnostic criteria applied. No statistically significant differences in clinical or hormonal parameters were observed between the three PCOS diagnostic groups (Ibáñez, Peña, and Rotterdam). However, patients meeting any PCOS definition differed significantly from those meeting no diagnostic criteria (NO PCOS group) in selected hormonal parameters: LH (p<0.001), total testosterone (p<0.001), androstenedione (p=0.003), and ovarian volume, consistent with established PCOS pathophysiology. The most frequent menstrual abnormality was "oligomenorrhea >45 days". Clinical hyperandrogenism was more common than biochemical hyperandrogenism (88.1%-91.5% vs. 54.9%-55.3%), indicating that clinical signs of androgen excess predominate in adolescents. Acne occurred in around 70% of girls with polycystic ovary syndrome and in less than 40% of those without it. Across all diagnostic definitions, ovarian volume was consistently higher in patients diagnosed with the syndrome, even in cases not meeting the traditional criteria for polycystic ovarian morphology. Conclusion: The high prevalence of polycystic ovary syndrome among adolescents underscores the need for standardized diagnostic approaches. Improved understanding of clinical and hormonal profiles in this population can facilitate earlier and more accurate diagnosis, enabling timely preventive and therapeutic interventions to reduce long-term metabolic and reproductive complications.