Polycystic ovary syndrome: clinical and menstrual pattern differences of adolescents

Abstract

Polycystic Ovary Syndrome (PCOS) affects 8 to 18% of women in reproductive age, (8) and it's an e ndocrinopathy with heterogeneous manifestation, characterized by menstrual alterations, hyperandrogenism, hirsutism, chronic anovulation and infertility. However, these criteria are controversial when applied to the diagnosis of PCOS in adolescents. Therefore, a description of the differential characteristics between physiological changes due to the immaturity of the Hypothalamus- Pituitary- Ovarian axis and Polycystic Ovary Syndrome would facilitate the management of these conditions in adolescents. Objectives: To analyze the differences in menstrual cycle patterns and the androgenic profile of adolescent with immaturity of the Hypothalamus - Pituitary - Ovarian axis and Polycystic Ovary Syndrome, through systematic review and meta-analysis. Methods: This review will be conducted according to the PRISMA guidelines. The data bases PubMed (https://www.ncbi.nlm.nih.gov/pubmed), EMBASE (https://www.embase.com), Web of Science (https://isiknowledge.com), Virtual Health Library (http://bvsalud.org) and Scopus (https://www.scopus.com) will be electronic searched using combination of the relevant MESH terms. The search will be restricted to English, Spanish and Portuguese languages, without the use of filters or delimiters. In order to amplify the scope of our search strategy, we will include articles from the gray literature, complete thesis documents and reference list of others articles and related reviews. Exclusion criteria: 1- Adolescents with comorbidities associated with PCOS or immaturity of the H-P-O axis; 2- Studies with pharmacological or surgical intervention; 3- Articles not related to the subject. Inclusion criteria: 1- Have a description of the menstrual cycle patterns or androgenic profile of adolescents with immaturity of the H-P-O axis or PCOS; 2- Be available for free to access to full text. We will present a narrative synthesis of the findings in each included study, structured around the menstrual pattern of each population. The studies quality will be measured using the Newcastle-Ottawa Scale (NOS), adapted to cross-sectional studies, and, if possible, a meta-analysis will be conducted. Expected Outcomes: It's expected that this systematic review and meta-analysis will be able to stablish normative values of menstrual patterns and androgenic profile of adolescents with immaturity of the Hypothalamus- Pituitary- Ovarian axis and with Polycystic Ovary Syndrome, facilitating the early diagnosis in case of PCOS and avoiding unnecessary interventions in adolescents with physiological age-specific changes.