Based on updated guidelines and expressed patient needs, we created a multidisciplinary clinic including endocrinology, gynecology/adolescent medicine, dermatology, psychology, and nutrition to provide comprehensive care to adolescent girls with polycystic ovary syndrome (PCOS). We describe the patient population presenting to this clinic and prescribing patterns when a multidisciplinary approach is utilized.
Retrospective chart review SETTING: Tertiary care hospital PARTICIPANTS: Female patients, ages 11-24 years, presenting for initial assessment in a multidisciplinary PCOS clinic INTERVENTIONS: None MAIN OUTCOME MEASURES: Medical history, physical exam findings, laboratory measurements and prescribed therapies RESULTS: 92 patients seen from 2014-2018 are described (age 15.9 years, range 11-24, BMI 35.6 kg/m, range 19.9-53.5). Metabolic syndrome features were common: 26% had a prediabetes hemoglobin A1c (>5.6%), 83% had a high-density lipoprotein (HDL) 120 mmHg, and 43% had an alanine aminotransferase >30 U/L. Dermatologic findings included: acne 93%, hirsutism 38%, acanthosis nigricans 85%, hidradenitis suppurativa 16%, and androgenic alopecia 2%. 33% had a diagnosis of depression or anxiety, 16% of patients had a diagnosis of obstructive sleep apnea, and an additional 59% had symptoms warranting a sleep study The most commonly prescribed medications were topical acne preparations (62%), followed by estrogen-containing hormonal therapy (56%) and metformin (40%).
In adolescents with PCOS and obesity, metabolic, dermatologic and psychologic co-morbidities are common. The use of a multidisciplinary clinic model including dermatology in addition to endocrinology, gynecology, psychology, and lifestyle experts provides care for most aspects of PCOS.

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