Comprehensive transition of care for polycystic ovary syndrome from adolescence to adulthood

Abstract

Polycystic ovary syndrome (PCOS) is a lifelong chronic condition that affects one in ten females and can be diagnosed in adolescence. As adolescents with PCOS transition to adulthood, counselling for lifestyle management and mental health concerns often transition from involving the family unit to increasingly individual-focused approaches. PCOS is associated with a large range of comorbidities affecting reproductive, metabolic, dermatological, and psychological health. The diagnosis and comorbidities of PCOS are influenced by pubertal hormones and need to be reassessed continuously to ensure that treatment remains appropriate for age and development. As young patients grow up, personal concerns often change, especially in relation to reproductive management. In this Review, we present prevalence rates, screening tools, and treatment recommendations for PCOS-related conditions, and we consider the diagnostic and clinical elements of optimal transition of care models that ensure continuity of comprehensive care for adolescents moving from the paediatric health-care system to the adult health-care system.

Figure 1.

Transition of PCOS care using the six core elements, a structured process of transition from pediatric to adult care models. *If a primary care clinician has already been managing PCOS, this condition will be a component of the overall transition of care plan. For a subspecialty pediatric PCOS clinician/team, this will be a coordinated effort with the primary care medical home to ensure all pieces of the patients’ PCOS care are represented in the broader transition plan. ^{^}Integration, as opposed to transfer of care, could apply for example to patients who have been followed by a family medicine clinician who can continue to see the individual across the lifespan. The primary clinician may or may not change, but the model of care delivery to match developmental age will. Abbreviation: SDoH=social determinants of health.