Invited review
Adolescent polycystic ovary syndrome: pathophysiology and implications of the disease

Polycystic ovary syndrome (PCOS) is one of the most prevalent female reproductive endocrinopathies, affecting many of women worldwide. We have reviewed the literature regarding the linkage between obesity, insulin resistance, and hyperinsulinemia in women with PCOS. Obesity has been reported as an epidemic in developed countries, in adults as well as adolescents. We have discussed the attempts to standardize the definition and diagnostic criteria for PCOS, most notably at the National Institutes of Health (NIH) conference of 1990, the Rotterdam conference of 2003, and the Androgen Excess Society (AES) conference held in 2006. The lack of defined criteria for adolescent PCOS is reviewed in this article. Additionally, the fascinating endocrine and metabolic disorders associated with the syndrome are discussed. Various models that have been proposed to explain the genetic nature of the disease: the “single-gene mendelian” model, the “multifactorial” model, and the “variable expression-single gene” model have also been enumerated. It is critical that the diagnosis of PCOS be made early and periodic screening is essential for the detection of the metabolic consequences of PCOS.