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| CLINICAL QUERIES |
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| Year : 2017 | Volume
: 15
| Issue : 1 | Page : 5 |
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Clinical questions - Responses to queries from readers: Polycystic ovarian syndrome
Sumi Thomas
Department of Pulmonary Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| Date of Web Publication | 17-Feb-2017 |
Correspondence Address:
Sumi Thomas
Department of Pulmonary Medicine, Christian Medical College, Vellore, Tamil Nadu
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0973-4651.200311
How to cite this article:
Thomas S. Clinical questions - Responses to queries from readers: Polycystic ovarian syndrome. Curr Med Issues 2017;15:5 |
| Question 2 | |  |
What is the ideal treatment of polycystic ovarian syndrome (PCOS) in an adolescent? What is the role of metformin in these individuals, especially because of the strong association with insulin resistance? What is the duration of treatment with metformin?
Management of adolescent polycystic ovarian syndrome (PCOS)[1] has always been a difficult problem. Management will depend on the problems faced by the adolescent. Once the diagnosis of PCOS is made, for those who are overweight or obese, lifestyle modification is the first line of treatment and this should be emphasized. For menstrual irregularities along with hirsutism and acne, hormonal contraceptives would be ideal. The duration of treatment is not yet determined. Hormonal contraceptives containing drospirenone may be used, but no one drug is superior to the other. Those in whom hirsutism does not respond to contraceptive pills may be given antiandrogens such as cyproterone acetate. Metformin should not be used as the first line but may be considered as a second-line option for those who do not tolerate hormonal contraceptives or for those who have associated type 2 diabetes mellitus/impaired glucose intolerance. In adolescents, it can be started as 500 mg once daily for a week and then twice daily for the next week and so one to a maximum of 1500–2000 mg/day. It may take at least 3 months to see a clinical effect. The duration of treatment is still unclear and is debatable.
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