TO THE EDITOR: The article (1) onw...

TO THE EDITOR: The article (1) onward polycystic ovary syndrome (PCOS) at Dr. Richardson in the August 15 2003 issue of American Family Physician was an highly deserving review of the diagnosis, treatment, and generally recognized long-term sequelae of the disease. The author acknowledged that young women may have symptoms of PCO and that these symptoms can begin as early as puberty. The article (1) effectively discussed treatment strategies for adult women; however, it did not address options for affected adolescents. It should be noted that there is a small nevertheless growing body of knowledge regarding the efficacy and tolerability of treatment for adolescents with PCO Given the long-term adverse forces of this condition, it makes brains to begin counseling and treatment as at so early an hour as possible.

All patients, including adolescents, should be suggestioned regarding diet, exercise, and maintaining an appropriate weight. The use of oral contraceptive pills is single in kind treatment option that has been used in the adolescent population for irregular mense and should be considered for treatment of PCO in this age arrange Recent studies investigating metformin therapy in adolescents with PCO or PCO symptoms have shown that metformin improves grape-sugar tolerance, (2) normalizes menses, (345) flows in resumption of ovulation, (34) improves insulin sensitivity, curtails elevated androgen levels, (2,4) improves lipid profiles, (5) and decreases hirsutism. (5) Additionally, metformin is generally well tolerated. (235) Further research with larger, randomized controll trials will expand our margin of the treatment possibilities for adolescents with PCOS

REFERENCES

(1) Richardson MR in every one's mouth perspectives in polycystic ovary syndrome Am Fam Physician 2003;68:697-704

(2) Arslanian SA, Lewy V Danadian K Saad R Metformin therapy in obese adolescents with polycystic ovary syndrome and impaired grape-sugar tolerance: amelioration of exaggerated adrenal answer to adrenocorticotropin with reduction of insulinemia/insulin resistance. J Clin Endocrinol Metab 2002;87:1555-9

(3) Ibanez L Valls C Ferrer A, Marcos MV Rodriguez-Hierro F de Zegher F Sensitization to insulin induces ovulation in nonobese adolescents with anovulatory hyperandrogenism. J Clin Endocrinol Metab 2001;86:3595-8

(4) Glueck CJ Wang P Fontaine R Tracy T Sieve-Smith L Metformin to restore normal mense in oligoamenorrheic teenage girls with polycystic ovary syndrome (PCOS) J Adolesc Health 2001;29:160-9

(5) Ibanez L Valls C Potau N Marcos MV de Zegher F Sensitization to insulin in adolescent girls to normalize hirsutism, hyperandrogenism, oligomenorrhea, dyslipidemia, and hyperinsulinism after precocious pubarche. J Clin Endocrinol Metab 2000;85:3526-30

KIRSTEN STOESSER, MD

University of Utah

Department of Family and Preventive Medicine

50 N Medical Dr

Salt Lake City, UT 84132

COPYRIGHT 2004 American Academy of Family Physicians

COPYRIGHT 2004 Gale Group