While ovulation is most likely to occur in adolescent girls with regular menstrual cycles, there are limited data on the incidence of ovulation in girls with irregular menstrual cycles in early postmenarcheal years. Centre for Research Excellence Associate Investigator, Dr Alexia Peña Vargas tells us about her recently published study evaluating the presence of ovulation in healthy postmenarcheal girls with irregular menstrual cycles.
As a paediatric endocrinologist who established an Adolescent Gynaecology and Endocrinology clinic, I have been reinforcing adolescent issues in PCOS within the CRE.
One of the main challenges of PCOS during adolescence is making the diagnosis. The diagnostic criteria have been derived from adult criteria that includes physiological events that may occur normally during puberty such as acne and menstrual irregularities. The only criteria that can be applied from diagnosis in adult women is ‘the need to exclude all other conditions that mimic PCOS’. This has been highlighted in our recent publication (Peña AS. What is adolescent polycystic ovary syndrome? J Paediatr Child Health).
I have been fortunate to be selected as the Australian representative in an international adolescent PCOS specialist consortium looking at the assessment and management of this condition. Members represent many societies including: the Australasian Paediatric Endocrine Group (APEG), Androgen Excess-PCOS Syndrome Society, Asia Pacific Pediatric Endocrine Society, African Society for Pediatric and Adolescent Endocrinology (AEPCOS), European Society for Pediatric Endocrinology, Japanese Society for Pediatric Endocrinology, North American Society of Pediatric and Adolescent Gynecology, Pediatric Endocrine Society, and the Latin American Society for Pediatric Endocrinology. (Most of these societies have participated in the recent meetings around the update and expansion of the evidence-based PCOS guidelines.) The work of this group has been accepted for publication in Hormone Research in Pediatrics, ‘An international consortium update: Pathophysiology, Diagnosis, and Treatment of Polycystic Ovarian Syndrome in Adolescence’.
It is known that many adult women with PCOS remain underdiagnosed or have a delayed diagnosis after seeing multiple health care providers for their symptoms which impacts negatively on their physical and emotional well-being. There have, however, been no studies in adolescents evaluating their diagnostic experience, knowledge and/or concerns. Thanks to an NHMRC CRE project support grant awarded last October, I will be evaluating the perceived knowledge and experiences of adolescents regarding PCOS diagnosis. This project will be done in collaboration with Melbourne-based clinical academics: Dr Melanie Gibson-Helm, Dr Anju Joham and Professor Helena Teede, all from MCHRI.
My active involvement in the Australasian Paediatric Endocrine Group (APEG) and the International Consortium of Pediatric Endocrinology (ICPE) aims to support the translation of the updated evidence-based guidelines to paediatricians and allied professionals and improve the care of adolescents with PCOS.
You can find out more about Alexia’s research, here.