Polycystic ovary syndrome in adolescence in Albania: diagnostic uncertainty and the risk of overdiagnosis

Abstract

Background: Diagnosing polycystic ovary syndrome (PCOS) during adolescence is inherently challeng- ing due to the overlap between normal pubertal physiology and pathological features of the syndrome. In Albania, the absence of adolescent-specific national guidelines and limited access to specialized multidis- ciplinary services may further increase diagnostic uncertainty and the risk of overdiagnosis. Objective: To critically examine diagnostic practices for adolescent PCOS in Albania and to propose pragmatic, evidence-based management strategies aimed at minimizing overdiagnosis while ensuring timely intervention for adolescents at genuine risk. Methods: This narrative, clinically based analysis integrates data from adolescents aged 11–19 years evaluated for suspected PCOS in Albanian healthcare settings, combined with contemporary internation- al evidence. Diagnostic criteria, treatment decisions, and follow-up outcomes were analyzed through a multidisciplinary clinical lens. Results: Menstrual irregularities and hyperandrogenic symptoms were common in early adolescence but often transient. Application of adult diagnostic criteria led to premature PCOS labeling in a subset of pa- tients. Lifestyle-focused management and longitudinal reassessment resulted in symptom resolution for many adolescents without the need for pharmacological therapy. Conclusion: A cautious, developmentally informed approach to adolescent PCOS is essential in Albania. Emphasizing diagnostic restraint, timely follow-up, and lifestyle-centered care can reduce overdiagnosis and the associated psychosocial burden.