KatCarney

March 5, 2003

Polycystic Ovary Syndrome (PCOS)

Early adrenarche often precedes PCOS

What was once labeled "benign premature adrenarche" may not be so benign after all. The early signs of puberty in girls younger than nine may be the first visible evidence of virilization caused by abnormally high androgen levels, followed by polycystic ovary syndrome (PCOS) in adolescence.[1]

Adolescent girls with (PCOS) often suffer from acne that persists into adulthood, as well as unwanted facial and body hair caused by the abnormally high level of adrenal androgens. Though some PCOS girls remain thin, many will experience an exceptional weight gain just prior to menarche. Most PCOS girls experience hyperinsulinism and irregular menstrual periods.

PCOS women suffer an increased risk of endometrial cancer, Type II diabetes, infertility, and cardiovascular disease.

The widespread increase in cases of premature adrenarche had been dismissed by some in the medical profession as "growing up early." The subsequent increase PCOS cases shows that premature adrenarche must now be taken more seriously:

Many girls with premature adrenarche show not only hyperinsulinemia already in the prepubertal period but also an increased incidence of ovulatory dysfunction, functional ovarian hyperandrogenism, dyslipidemia, and obesity at adolescence, indicating long-term follow-up of these patients into adulthood.[1]

Early treatment of premature adrenarche with the methods already developed for congenital adrenal hyperplasia (CAH) can usually prevent further virilization. In CAH children, this has long been effective in combatting the rise of virilizing hormones and the resultant early onset of puberty. It is not yet known how effective such methods will be in preventing early puberty or PCOS in girls with premature adrenarche.

1. Endocrine Reviews 21 (6): 671-696

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