Oral Contraceptives and the Management of Hyperandrogenism–Polycystic Ovary Syndrome in Adolescents Paula J. Adams Hillard, MD a,b, * a University of Cincinnati College of Medicine, Cincinnati, OH, USA b Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA Hyperandrogenism–polycystic ovary syndrome (PCOS) is the most common endocrinologic condition in adult women, occurring in 5% to 10% of women [1–3]. Most women with PCOS report that their symptoms began during adolescence. It has been suggested that women with PCOS have at least some form of the syndrome ‘‘throughout life’’ [4]. Far too frequently however, the symptoms of PCOS, irregular periods, acne, and weight gain, are attributed to normal puberty and adolescence, with the mistaken belief that girls will outgrow them. Girls often suffer needlessly, and the manifestations of hyperandrogenism may lead to lowered self esteem and a lower health-related quality of life at a crucial time in a young woman’s psychosocial development [5,6]. Girls with PCOS may have a variety of symptoms and complaints, from primary amenorrhea to ab- normal bleeding and acne, which may bring them to their primary clinician, a pediatrician, a gynecologist, or a dermatologist. Frequently, adolescents and their parents do not recognize that these and other complaints, such as obesity, are related and believe that obesity, excess hair growth, and irregular menstrual cycles may ‘‘run in the family,’’ and thus not view these conditions as abnormal. Vigilance and awareness of the syndrome of PCOS among primary clinicians is of utmost importance in making the diagnosis that may have real and significant implications for future health. Appropriate management of PCOS depends on recognizing the syndrome, which can have a variety of presenting complaints and must be differentiated from other causes of hyperandrogenism [7]. Because of the potential risk for * Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, ML 4000, Cincinnati, OH 45229. E-mail address: paula.hillard@cchmc.org 0889-8529/05/$ - see front matter Ó 2005 Elsevier Inc. All rights reserved. doi:10.1016/j.ecl.2005.04.012 endo.theclinics.com Endocrinol Metab Clin N Am 34 (2005) 707–723