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Arch Pediatr Adolesc Med. 2008 Jun;162(6):521-5. doi: 10.1001/archpedi.162.6.521.

Primary amenorrhea as a manifestation of polycystic ovarian syndrome in adolescents: a unique subgroup?

Author information

1
Division of Pediatrics, Assaf Harofeh Medical Center, Tel Aviv University, Zerifin, Israel 70300. rmarianna@gmail.com

Abstract

OBJECTIVE:

To compare clinical and metabolic features of adolescents having primary amenorrhea (PA) and polycystic ovarian syndrome (PCOS) with those having oligomenorrhea or secondary amenorrhea (OM/SA) and PCOS.

DESIGN:

Retrospective case-control study.

SETTING:

Endocrine Gynecology Clinic at The Hospital for Sick Children, Toronto, Ontario, Canada.

PATIENTS:

Girls and young women aged 14 to 18 years having PA and PCOS (n = 9) seen during a 2(1/2)-year period were compared with control subjects having OM/SA and PCOS (n = 18) randomly selected during the same period.

INTERVENTION:

Medical record review was performed to assess clinical, biochemical, and ultrasonographic measures, as well as response to a progesterone challenge.

MAIN OUTCOME MEASURES:

Differences in response to the progesterone challenge, hyperandrogenism, and the presence of features of the metabolic syndrome.

RESULTS:

Compared with adolescents having OM/SA, adolescents having PA demonstrated older age at pubarche, higher androstenedione levels, greater prevalence of family history of obesity, a tendency toward no withdrawal bleeding in response to the progesterone challenge, and more features associated with the metabolic syndrome (acanthosis nigricans, higher diastolic blood pressure, and lower high-density lipoprotein cholesterol level). No significant correlation was demonstrated between response to the progesterone challenge, metabolic features, and androstenedione levels.

CONCLUSION:

Adolescents with PA and PCOS exhibit increased features of the metabolic syndrome and higher androstenedione levels and may represent a more severe spectrum of a common condition.

PMID:
18524741
DOI:
10.1001/archpedi.162.6.521
[Indexed for MEDLINE]

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