eMedicine Specialties > Pediatrics: General Medicine > Endocrinology

Polycystic Ovarian Syndrome: Follow-up

Author: Robert J Ferry Jr, MD,, Chief, Division of Pediatric Endocrinology and Metabolism, Le Bonheur Children's Medical Center, University of Tennessee Health Science Center at Memphis, and St. Jude Children's Research Hospital; Brigade Surgeon, 36th Sustainment Brigade, 13th Expeditionary Sustainment Command, U.S. Army
Contributor Information and Disclosures

Updated: Oct 21, 2009

Follow-up

Further Inpatient Care

  • The only indication for inpatient care in patients with polycystic ovarian syndrome (PCOS) is menorrhagia with severe anemia.

Further Outpatient Care

  • Monitor oral contraceptive pill (OCP) use.
  • Monitor for adverse effects of medications.
  • Monitor for insulin resistance and development of diabetes.
  • Monitor lipid profile.
  • Encourage exercise and a healthy diet.

Complications

  • Type 2 diabetes mellitus
  • Cardiovascular disease
  • Endometrial carcinoma
  • Infertility

Prognosis

  • Prognosis is good.

Patient Education

 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous authors Kathy Silverman and Elizabeth Alderman to the original writing of this article.



More on Polycystic Ovarian Syndrome

Overview: Polycystic Ovarian Syndrome
Differential Diagnoses & Workup: Polycystic Ovarian Syndrome
Treatment & Medication: Polycystic Ovarian Syndrome
Follow-up: Polycystic Ovarian Syndrome
Multimedia: Polycystic Ovarian Syndrome
References

References

  1. Stein IF, Leventhal ML. Amenorrhea associated with bilateral polycystic ovaries. Am J Obstet Gynecol. 1935;29:181-91.

  2. Azziz R, Carmina E, Dewailly D, et al. The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertil Steril. Feb 2009;91(2):456-88. [Medline].

  3. Rosenfield RL, Barnes RB, Cara JF, Lucky AW. Dysregulation of cytochrome P450c 17 alpha as the cause of polycystic ovarian syndrome. Fertil Steril. 1990;53:785-91. [Medline].

  4. Govind A, Obhrai MS, Clayton RN. Polycystic ovaries are inherited as an autosomal dominant trait. J Clin Endocrinol Metab. 1961;21:1440.

  5. Nur MM, Newman IM, Siqueira LM. Glucose Metabolism in Overweight Hispanic Adolescents With and Without Polycystic Ovary Syndrome. Pediatrics. Aug 24 2009;[Medline].

  6. Thessaloniki ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Consensus on infertility treatment related to polycystic ovary syndrome. Fertil Steril. Mar 2008;89:505-22. [Medline].

  7. [Guideline] Martin KA, Chang RJ, Ehrmann DA, Ibanez L, Lobo RA, Rosenfield RL, et al. Evaluation and treatment of hirsutism in premenopausal women: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2008;93:1105-20. [Medline].

  8. [Best Evidence] Otta CF, Wior M, Iraci GS, et al. Clinical, metabolic, and endocrine parameters in response to metformin and lifestyle intervention in women with polycystic ovary syndrome: A randomized, double-blind, and placebo control trial. Gynecol Endocrinol. Aug 2009;1-6. [Medline].

  9. [Best Evidence] Begum MR, Khanam NN, Quadir E, et al. Prevention of gestational diabetes mellitus by continuing metformin therapy throughout pregnancy in women with polycystic ovary syndrome. J Obstet Gynaecol Res. Apr 2009;35:282-6. [Medline].

  10. Allen HF, Mazzoni C, Heptulla RA, et al. Randomized controlled trial evaluating response to metformin versus standard therapy in the treatment of adolescents with polycystic ovary syndrome. J Pediatr Endocrinol Metab. 2005;18:761-768. [Medline].

  11. Moghetti P, Castello R, Negri C, et al. Metformin effects on clinical features, endocrine and metabolic profiles, and insulin sensitivity in polycystic ovary syndrome: a randomized, double-blind, placebo-controlled 6-month trial, followed by open, long-term clinical evaluation. J Clin Endocrinol Metab. 2000;85:139-46. [Medline][Full Text].

  12. Arslanian SA. Clamp techniques in paediatrics: what have we learned?. Horm Res. 2005;64:16-24. [Medline].

  13. Barbieri RL, Ryan KJ. Hyperandrogenism, insulin resistance, and acanthosis nigricans syndrome: a common endocrinopathy with distinct pathophysiologic features. Am J Obstet Gynecol. Sep 1 1983;147(1):90-101. [Medline].

  14. Burke JP, Duggirala R, Hale DE, et al. Genetic basis of acanthosis nigricans in Mexican Americans and its association with phenotypes related to type 2 diabetes. Hum Genet. 2000;106:467-472. [Medline].

  15. Burke JP, Hale DE, Hazuda HP, Stern MP. A quantitative scale of acanthosis nigricans. Diabetes Care. 1999;22:1655-1699. [Medline][Full Text].

  16. Burkman RT Jr. The role of oral contraceptives in the treatment of hyperandrogenic disorders. Am J Med. Jan 16 1995;98(1A):130S-136S. [Medline].

  17. Carmina E, Koyama T, Chang L, et al. Does ethnicity influence the prevalence of adrenal hyperandrogenism and insulin resistance in polycystic ovary syndrome?. Am J Obstet Gynecol. 1992;167:1807-12. [Medline].

  18. Castelo-Branco C, Martinez de Osaba MJ, Pons F, Fortuny A. Gonadotropin-releasing hormone analog plus an oral contraceptive containing desogestrel in women with severe hirsutism: effects on hair, bone, and hormone profile after 1-year use. Metabolism. Apr 1997;46(4):437-40. [Medline].

  19. Cruz ML, Shaibi GQ, Weigensberg MJ, et al. Pediatric obesity and insulin resistance: chronic disease risk and implications for treatment and prevention beyond body weight modification. Annu Rev Nutr. 2005;25:435-468. [Medline].

  20. Cumming DC, Yang JC, Rebar RW, Yen SS. Treatment of hirsutism with spironolactone. JAMA. Mar 1982;247:1295-8. [Medline].

  21. Denburg MR, Silfen ME, Manibo AM, et al. Insulin sensitivity and the insulin-like growth factor system in prepubertal boys with premature adrenarche. J Clin Endocrinol Metab. 2002;87:5604-5609. [Medline][Full Text].

  22. Ehrmann DA. Relation of functional ovarian hyperandrogenism to non-insulin dependent diabetes mellitus. Baillieres Clin Obstet Gynaecol. Jun 1997;11(2):335-47. [Medline].

  23. Ehrmann DA, Barnes RB, Rosenfield RL. Polycystic ovary syndrome as a form of functional ovarian hyperandrogenism due to dysregulation of androgen secretion. Endocr Rev. Jun 1995;16(3):322-53. [Medline][Full Text].

  24. Elkind-Hirsch KE, Anania C, Mack M, Malinak R. Combination gonadotropin-releasing hormone agonist and oral contraceptive therapy improves treatment of hirsute women with ovarian hyperandrogenism. Fertil Steril. May 1995;63(5):970-8. [Medline].

  25. Ferriman D, Gallwey JD. Clinical assessment of body hair growth in women. J Clin Endocrinol Metab. 1961;21:1440.

  26. Franks S. Polycystic ovary syndrome [published erratum appears in N Engl J Med 1995;333:1435]. N Engl J Med. 1995;333:853-61. [Medline].

  27. Glueck CJ, Goldenberg N, Pranikoff J, et al. Height, weight, and motor-social development during the first 18 months of life in 126 infants born to 109 mothers with polycystic ovary syndrome who conceived on and continued metformin through pregnancy. Hum Reprod. 2004;19:1323-1330. [Medline][Full Text].

  28. Goldfarb A. Menstrual dysfunction. In: Coupey S, ed. Coupey's Primary Care of Adolescent Girls. Hanley and Belfus, Inc; 2000:258.

  29. Gubitosi-Klug RA, Martinez A, Mericq V, Palmert MR. Drugs and hormones used to treat pediatric and adolescent reproductive endocrine disorders. Pediatr Endocrinol Rev. 2004;2:93-107. [Medline].

  30. Holmes KW, Kwiterovich PO Jr. Treatment of dyslipidemia in children and adolescents. Curr Cardiol Rep. 2005;7:445-456. [Medline].

  31. Ibanez L, Valls C, Marcos MV, et al. Insulin sensitization for girls with precocious pubarche and with risk for polycystic ovary syndrome: effects of prepubertal initiation and postpubertal discontinuation of metformin treatment. J Clin Endocrinol Metab. 2004;89:4331-4337. [Medline][Full Text].

  32. Leibel NI, Baumann EE, Kocherginsky M, Rosenfield RL. Relationship of adolescent polycystic ovary syndrome to parental metabolic syndrome. J Clin Endocrinol Metab. 2006;91:1275-1283. [Medline].

  33. McClamrock H, Adashi EY. Polycystic ovarian syndrome and associated hirsutism in the adolescent. Adolesc Pediatr Gynecol. 1992;5:231-41.

  34. Musso C, Cochran E, Javor E. The long-term effect of recombinant methionyl human leptin therapy on hyperandrogenism and menstrual function in female and pituitary function in male and female hypoleptinemic lipodystrophic patients. Metabolism. 2005;54:255-263.

  35. Musso C, Cochran E, Moran SA, et al. Clinical course of genetic diseases of the insulin receptor (type A and Rabson-Mendenhall syndromes): a 30-year prospective. Medicine (Baltimore). 2004;83:209-222. [Medline].

  36. Myers ER, Silva SG, Hafley G, et al. Estimating live birth rates after ovulation induction in polycystic ovary syndrome: sample size calculations for the pregnancy in polycystic ovary syndrome trial. Contemp Clin Trials. 2005;26:271-80. [Medline].

  37. Polson DW, Adams J, Wadsworth J, Franks S. Polycystic ovaries--a common finding in normal women. Lancet. 1988;1(8590):870-2. [Medline].

  38. Rebar R, Judd HL, Yen SS, et al. Characterization of the inappropriate gonadotropin secretion in polycystic ovary syndrome. J Clin Invest. 1976;57:1320-9. [Medline][Full Text].

  39. Siow Y, Kives S, Hertweck P, et al. Serum Mullerian-inhibiting substance levels in adolescent girls with normal menstrual cycles or with polycystic ovary syndrome. Fertil Steril. 2005;84:938-944. [Medline].

  40. Styne DM. Review of the 2nd Annual World Congress on the Insulin Resistance Syndrome. J Pediatr Endocrinol Metab. 2005;18:723-726. [Medline].

  41. Ten S, Maclaren N. Insulin resistance syndrome in children. J Clin Endocrinol Metab. 2004;89:2526-2539. [Medline][Full Text].

  42. Trent ME, Rich M, Austin SB, Gordon CM. Fertility concerns and sexual behavior in adolescent girls with polycystic ovary syndrome: implications for quality of life. J Pediatr Adolesc Gynecol. Feb 2003;16(1):33-7. [Medline].

  43. Wong IL, Morris RS, Chang L, et al. A prospective randomized trial comparing finasteride to spironolactone in the treatment of hirsute women. J Clin Endocrinol Metab. 1995;80:233-8. [Medline].

  44. Yoo RY, Dewan A, Basu R, et al. Increased luteinizing hormone pulse frequency in obese oligomenorrheic girls with no evidence of hyperandrogenism. Fertil Steril. 2006;85:1049-1056. [Medline].

  45. Zukauskaite S, Seibokaite A, Lasas L, et al. Serum hormone levels and anthropometric characteristics in girls with hyperandrogenism. Medicina (Kaunas). 2005;41:305-312. [Medline].

Further Reading

Keywords

polycystic ovarian syndrome, PCOS, Stein-Leventhal syndrome, hyperandrogenism, functional ovarian hyperandrogenism, sclerocystic disease of the ovary, insulin resistance, perimenarchal onset, amenorrhea, obesity, menstrual dysfunction, HAIR-AN syndrome, treatment, diagnosis

Contributor Information and Disclosures

Author

Robert J Ferry Jr, MD,, Chief, Division of Pediatric Endocrinology and Metabolism, Le Bonheur Children's Medical Center, University of Tennessee Health Science Center at Memphis, and St. Jude Children's Research Hospital; Brigade Surgeon, 36th Sustainment Brigade, 13th Expeditionary Sustainment Command, U.S. Army
Robert J Ferry Jr, MD, is a member of the following medical societies: American Academy of Pediatrics, American Diabetes Association, American Medical Association, Endocrine Society, Lawson-Wilkins Pediatric Endocrine Society, Society for Pediatric Research, and Texas Pediatric Society
Disclosure: Nutropin Speakers Bureau Honoraria Speaking and teaching; Genotropin Speakers Bureau Honoraria Speaking and teaching; Eli Lilly & Co. Grant/research funds Independent contractor; MacroGenics, Inc. Grant/research funds Independent contractor; Ipsen, S.A. (formerly Tercica, Inc.) Grant/research funds Independent contractor

Medical Editor

Phyllis W Speiser, MD, Chief of Pediatric Endocrinology, Schneider Children's Hospital; Professor of Pediatrics, New York University School of Medicine
Phyllis W Speiser, MD is a member of the following medical societies: American Association of Clinical Endocrinologists, Endocrine Society, Lawson-Wilkins Pediatric Endocrine Society, and Society for Pediatric Research
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

Lynne Lipton Levitsky, MD, Chief, Pediatric Endocrine Unit, Massachusetts General Hospital; Associate Professor, Department of Pediatrics, Harvard University Medical School
Lynne Lipton Levitsky, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American Diabetes Association, American Pediatric Society, Endocrine Society, Lawson-Wilkins Pediatric Endocrine Society, and Society for Pediatric Research
Disclosure: Pfizer Grant/research funds P.I.; Tercica Grant/research funds PI, also occasional consultant

CME Editor

Merrily P M Poth, MD, Professor, Department of Pediatrics and Neuroscience, Uniformed Services University of the Health Sciences
Merrily P M Poth, MD is a member of the following medical societies: American Academy of Pediatrics, Endocrine Society, and Lawson-Wilkins Pediatric Endocrine Society
Disclosure: Nothing to disclose.

Chief Editor

Stephen Kemp, MD, PhD, Professor, Department of Pediatrics, Section of Pediatric Endocrinology, University of Arkansas and Arkansas Children's Hospital
Stephen Kemp, MD, PhD is a member of the following medical societies: American Academy of Pediatrics, American Association of Clinical Endocrinologists, American Pediatric Society, Endocrine Society, Phi Beta Kappa, Southern Medical Association, and Southern Society for Pediatric Research
Disclosure: Genentech, Inc. Honoraria Speaking and teaching; Pfizer, Inc. Honoraria Consulting

 
 
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