Diagnosing polycystic ovary syndrome (PCOS) during adolescence is challenging because features of normal pubertal development overlap with adult diagnostic criteria. The international evidence-based PCOS Guideline aimed to promote accurate and timely diagnosis, to optimise consistent care, and to improve health outcomes for adolescents and women with PCOS. International healthcare professionals, evidence synthesis teams and consumers informed the priorities, reviewed published data and synthesised the recommendations for the Guideline. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework was applied to appraise the evidence quality and the feasibility, acceptability, cost, implementation and strength of the recommendations. This paper focuses on the specific adolescent PCOS Guideline recommendations. Specific criteria to improve diagnostic accuracy and avoid over diagnosis include: (1) irregular menstrual cycles defined according to years post-menarche; > 90 days for any one cycle (> 1 year post-menarche), cycles< 21 or > 45 days (> 1 to < 3 years post-menarche); cycles < 21 or > 35 days (> 3 years post-menarche) and primary amenorrhea by age 15 or > 3 years post-thelarche. Irregular menstrual cycles (< 1 year post-menarche) represent normal pubertal transition. (2) Hyperandrogenism defined as hirsutism, severe acne and/or biochemical hyperandrogenaemia confirmed using validated high-quality assays. (3) Pelvic ultrasound not recommended for diagnosis of PCOS within 8 years post menarche. (4) Anti-Müllerian hormone levels not recommended for PCOS diagnosis; and (5) exclusion of other disorders that mimic PCOS. For adolescents who have features of PCOS but do not meet diagnostic criteria an ‘at risk’ label can be considered with appropriate symptomatic treatment and regular re-evaluations. Menstrual cycle re-evaluation can occur over 3 years post menarche and where only menstrual irregularity or hyperandrogenism are present initially, evaluation with ultrasound can occur after 8 years post menarche. Screening for anxiety and depression is required and assessment of eating disorders warrants consideration. Available data endorse the benefits of healthy lifestyle interventions to prevent excess weight gain and should be recommended. For symptom management, the combined oral contraceptive pill and/or metformin may be beneficial. Extensive international engagement accompanied by rigorous processes honed both diagnostic criteria and treatment recommendations for PCOS during adolescence.

中文翻译：

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根据国际循证指南，青春期多囊卵巢综合征。

在青春期期间诊断多囊卵巢综合征（PCOS）具有挑战性，因为正常青春期发育的特征与成人诊断标准重叠。基于国际证据的《 PCOS指南》旨在促进准确，及时的诊断，优化一致的护理以及改善PCOS青少年和妇女的健康状况。国际卫生保健专业人员，证据综合小组和消费者告知了优先事项，审查了已发表的数据并综合了该指南的建议。建议，评估，发展和评估分级（GRADE）框架用于评估证据质量以及建议的可行性，可接受性，成本，实施和强度。本文着重于PCOS青春期指南的具体建议。提高诊断准确性和避免过度诊断的具体标准包括：（1）根据初潮后的年龄定义不规则的月经周期；>任意一个周期> 90天（初潮后> 1年），<21或> 45天（初潮后> 1至<3年）；周期<21或> 35天（初潮后> 3年）和原发性闭经，直到15岁或> 3年。月经周期不规律（初潮后<1年）代表正常的青春期过渡。（2）高雄激素血症定义为多毛症，严重痤疮和/或生化高雄激素血症，已通过有效的高质量检测方法证实。（3）初潮后8年内不建议盆腔超声检查诊断PCOS。（4）不推荐将抗苗勒氏管激素水平用于PCOS诊断；（5）排除其他模仿PCOS的疾病。对于具有PCOS特征但不符合诊断标准的青少年，可以考虑采用“有风险”的标签，并进行适当的对症治疗和定期的重新评估。月经周期的重新评估可以在初潮后3年内进行，并且最初仅存在月经不调或雄激素过多的地方，在初潮后8年内可以进行超声检查。需要筛查焦虑和抑郁，评估饮食失调值得考虑。现有数据支持健康的生活方式干预措施的益处，以防止体重增加过多，因此应予以推荐。对于症状管理，口服避孕药和/或二甲双胍联合使用可能是有益的。