Adolescent hyperandrogenism: diagnostic challenges and therapeutic approaches
- 11.09.2025
- Review Article
Erschienen in:
- Verfasst von
- Marcio J. Concepción-Zavaleta
- Jenyfer M. Fuentes-Mendoza
- Francisca E. Zavaleta-Gutiérrez
- Bryan Y. Arias-Cantor
- Maria V. Figueredo-Rueda
- Julia C. Coronado-Arroyo
- José Paz-Ibarra
- Erschienen in
- World Journal of Pediatrics | Ausgabe 10/2025
Abstract
Background
Hyperandrogenism represents a prevalent yet diagnostically challenging endocrine condition in adolescents, with polycystic ovary syndrome (PCOS), non-classic congenital adrenal hyperplasia, and androgen-secreting tumors constituting the most common etiologies. The physiological overlap with normal pubertal development creates significant diagnostic complexity, necessitating evidence-based approaches tailored to this unique population.
Data sources
This narrative review synthesizes evidence from a comprehensive literature search (PubMed/Scopus/Web of Science/EMBASE/Cochrane, 2000–2025) evaluating diagnostic and therapeutic approaches for adolescent hyperandrogenism. We prioritized clinical practice guidelines (including 2023 international PCOS guidelines), randomized controlled trials, and large cohort studies (n ≥ 50), excluding conference abstracts and non-peer-reviewed sources. Data extraction focused on diagnostic accuracy, treatment efficacy, safety profiles, and quality-of-life outcomes across 122 included studies.
Results
Current diagnostic frameworks demonstrate critical limitations in adolescent populations, particularly regarding age-specific biochemical cutoffs (testosterone, dehydroepiandrosterone sulphate, and 17-hydroxyprogesterone) and imaging interpretation. While combined oral contraceptives remain first-line therapy, emerging data highlight both metabolic risks (particularly with long-term use) and the potential of insulin sensitizers such as myo-inositol. Psychological comorbidities (anxiety, depression) are prevalent (38%–45% prevalence) yet are frequently under-addressed in clinical management. Key knowledge gaps persist regarding optimal (1) diagnostic thresholds for diverse ethnic groups; (2) longitudinal safety of hormonal therapies; and (3) integrated mental health interventions.
Conclusions
Adolescent hyperandrogenism demands multidisciplinary management involving endocrinologic, gynecologic, dermatologic, and psychological expertise. Future research must prioritize (1) validated age- and puberty-stage-specific diagnostic criteria; (2) safety/efficacy data for emerging therapies; and (3) standardized protocols for mental health screening. This synthesis provides a framework for evidence-based, individualized care while highlighting urgent research priorities.
Graphical abstract
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- Titel
- Adolescent hyperandrogenism: diagnostic challenges and therapeutic approaches
- Verfasst von
-
Marcio J. Concepción-Zavaleta
Jenyfer M. Fuentes-Mendoza
Francisca E. Zavaleta-Gutiérrez
Bryan Y. Arias-Cantor
Maria V. Figueredo-Rueda
Julia C. Coronado-Arroyo
José Paz-Ibarra
- Publikationsdatum
- 11.09.2025
- Verlag
- Springer Nature Singapore
- Erschienen in
-
World Journal of Pediatrics / Ausgabe 10/2025
Print ISSN: 1708-8569
Elektronische ISSN: 1867-0687 - DOI
- https://doi.org/10.1007/s12519-025-00972-w
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