The Journal of Clinical Endocrinology & Metabolism (JCEM)Approach to the Diagnosis and Treatment of Polycystic Ovarian Syndrome in Adolescent Patients

Editorial Note: This summary uses “PCOS” throughout, reflecting terminology in the source publication (May 2026). As of May 12, 2026, the condition has been officially renamed polyendocrine metabolic ovarian syndrome (PMOS) via global consensus published in The Lancet. Both terms will remain in active clinical use during a three-year transition period.

🎓 Expert Commentary / Peer Perspective

Authors from the University of São Paulo’s Developmental Endocrinology Unit synthesized current evidence on adolescent PMOS, emphasizing that pubertal physiology overlaps with core PCOS features, creating meaningful underdiagnosis and overdiagnosis risk if a single-criterion approach is applied.

Clinical Considerations

• Definitive diagnosis requires persistent hyperandrogenism and menstrual irregularity; one feature alone warrants longitudinal monitoring, not a diagnosis.
• Several conditions mimic adolescent PCOS; exclusion of alternatives is flagged as essential before labeling.
• PCOS carries long-term metabolic and adverse mental health risk beyond reproductive dysfunction, underscoring the stakes of both under- and overdiagnosis.
• Pharmacotherapy is individualized by clinical presentation, metabolic profile, contraindications, and patient preferences; it is not applied uniformly.

Practice Applications

• Consider COCs as first-line for menstrual irregularity and hyperandrogenism, with reproductive health counseling integrated.
• Consider metformin as first-line for metabolic comorbidities, consistent with adult-population recommendations.
• Monitor single-feature adolescents longitudinally rather than applying or withholding a PCOS diagnosis prematurely.
• Recognize that full treatment detail was not available for review; access the complete JCEM article for differential workup specifics and threshold guidance.