In most cases, hyperandrogenism in adolescence is related to a nascent PCOS. Since the laboratory and ultrasonic findings are often not conclusive at this age, the diagnosis may remain presumptive providing other diagnoses have been ruled out and the follow-up does not disclose any atypical evolution.

Although considered as a benign disease, PCOS may sometimes severely affect the psychological and social behavior of patients. First, hirsutism and other clinical manifestations of hyperandrogenism may induce poor self-image, and this is particularly crucial at the time of adolescence. Second, anxiety may develop about the fertility prognosis. Lastly, the metabolic long-term risks may threaten some patients excessively. Therefore, when PCOS is diagnosed in an individual adolescent or young woman, the clinician should have a long conversation with her, explaining gently and simply what PCOS means in terms of prognosis for her physical and mental health. The right way is a narrow track, between a guilty silence and anxiogenic medical overactivism.

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