Comparison of PCOS phenotypes in adolescent and young adult Mediterranean women with possible PCOS

J Endocrinol Invest. 2021 May;44(5):995-1000. doi: 10.1007/s40618-020-01394-3. Epub 2020 Aug 24.


Purpose: During adolescence, PCOS features are supposed to be in evolution. Because of this, the diagnosis of PCOS in adolescence is often unclear and few studies have compared adolescent and adult PCOS phenotype distribution and features. The aim is to compare phenotypes in adolescents and young adults with PCOS.

Methods: 109 girls aged from 13 to 19 years were retrospectively studied. All patients had a gynecological age > 2 years. 63 patients were adolescents (3-5 years beyond menarche) while 46 patients were young adults (6-9 years beyond menarche). Diagnosis of different PCOS phenotypes (A, B, C, D) was made according to the Rotterdam criteria. Clinical data (menstrual cycles, BMI, presence of hirsutism), androgen circulating levels (total testosterone, androstenedione, dehydroepiandrosterone sulphate) and ovarian morphology by ultrasound were assessed.

Results: 109 patients presented PCOS according to the Rotterdam criteria. Phenotype A was by far the most common phenotype (73.4%) followed by phenotype B (21.1%). Only few patients had phenotype C (4.6%) or phenotype D (0.9%). When patients were divided in two groups (adolescent and young adult patients), no significant difference in prevalence and features of the different phenotypes was observed.

Conclusion: In this cohort of adolescent and young adult women with PCOS, the progression of age does not change the prevalence and the features of main PCOS phenotypes. It suggests that the Rotterdam criteria might be used also in adolescents, at least in those with 2 or more years of gynecological age, for the diagnosis of PCOS.

Keywords: Adolescence; PCOS; PCOS phenotypes; Rotterdam criteria.

MeSH terms

  • Adolescent
  • Androgens / blood*
  • Body Mass Index
  • Early Diagnosis
  • Female
  • Hirsutism* / diagnosis
  • Hirsutism* / metabolism
  • Humans
  • Italy / epidemiology
  • Menarche / metabolism*
  • Ovary / diagnostic imaging*
  • Phenotype
  • Polycystic Ovary Syndrome* / diagnosis
  • Polycystic Ovary Syndrome* / epidemiology
  • Polycystic Ovary Syndrome* / metabolism
  • Polycystic Ovary Syndrome* / physiopathology
  • Prevalence
  • Ultrasonography / methods
  • Young Adult


  • Androgens