Čes-slov Pediat 2026, 81(88):47-53

Diagnostic and therapeutic recommendations for polyendocrine metabolic ovarian syndrome in girls with obesity

Renata Pilcová

Oddělení obezitologie, Endokrinologický ústav, Praha

Polyendocrine metabolic ovarian syndrome (PMOS) is one of the most common endocrine disorders in women of reproductive age and can manifest already during adolescence. PMOS is characterized by hyperandrogenism (clinical and/or biochemical) and ovarian dysfunction.

However, in adolescent girls, the diagnosis is often made in the presence of overlap with normal pubertal changes (e.g., menstrual irregularities or acne). Overweight and obesity in girls increase the risk of metabolic complications of PMOS and may worsen its symptoms. If left untreated, especially in the context of obesity, PMOS can lead to fertility issues, metabolic complications of obesity,

cardiovascular diseases, and an increased risk of endometrial cancer.

The manifestations of PMOS also affect the mental health of girls and women. Due to the increasing number of obese adolescent girls, a rise in the number of women diagnosed with PMOS can be expected. Despite this trend, insufficient attention is paid to the diagnosis and treatment of PMOS in obese adolescent girls. Diagnosing

PMOS during adolescence can be particularly challenging, as it often overlaps with pronounced pubertal changes (such as irregular menstrual cycles, acne, and polycystic ovaries).

There are still no consistent, evidence-based diagnostic approaches, mainly due to the lack of sufficient studies focused on adolescent girls. The first-line treatment for PMOS is lifestyle modification, especially in

cases where the syndrome is accompanied by obesity. Pharmacological treatment of PMOS in adolescents is not standardized. The long-term effects of various treatment methods have not yet been adequately evaluated; therefore, medications should be prescribed with caution. With the emergence of new pharmacological options for obesity - also in adolescents - it is likely that PMOS can be managed

earlier and more effectively.

PMOS remains not fully understood, and its symptoms vary among individual girls and women. Therefore, treatment should be approached on a case-by-case basis, including psychological care, which is often necessary for managing the syndrome. This article aims to present the latest findings on PMOS with a focus on simple, practically oriented diagnosis and treatment in obese adolescent girls.

Keywords: polyendocrine metabolic ovarian syndrome, androgens, obesity, hirsutism, adolescent, insulin resistance

Received: October 31, 2025; Revised: October 31, 2025; Accepted: January 30, 2026; Published: March 1, 2026  Show citation