Fifteen-minute consultation: The overweight teenage girl with acne

Polycystic ovary syndrome (PCOS) is a common endocrine condition which often presents in adolescence. The symptoms and signs, which include obesity, acne, hirsutism and irregular menstrual periods, can have profound psychosocial, metabolic and reproductive consequences. Diagnosis in the adolescent population can be particularly difficult as there is significant overlap between the clinical features of PCOS and those of normal pubertal development. International guidelines published in 2018 have produced diagnostic criteria for adolescents to aid the physician, but there will still be many cases in which diagnostic uncertainty remains. In this article, we present a structured approach to adolescents with symptoms of PCOS, covering clinical assessment, investigation, diagnosis and management. We emphasise that intervention, with lifestyle advice and combined oral contraception should be considered even in the absence of a definitive diagnosis.

Keywords: adolescent health; endocrinology; general paediatrics.