LONGITUDINAL CHANGE OF SONOGRAPHIC OVARIAN ASPECTS AND ENDOCRINE PARAMETERS IN IRREGULAR CYCLES OF ADOLESCENCE

We longitudinally studied clinical endocrine and ultrasound parameters of the ovaries in 73 healthy adolescents having persistent menstrual irregularities. After the first examination, they were reexamined afte r a variable period ranging from 2 to 7 y. During the first examinatio n, three basic features of the ovaries were observed: homogeneous (36% ), multifollicular (23%), and polycystic (41%). Polycystic ovaries wer e most frequent, and they generally exceeded the normal adult range. D uring the last examination, in the entire group of irregular adolescen ts, homogeneous ovaries decreased (-14%), polycystic ovaries increased (+18%), and a further higher number of subjects exceeded the normal a dult range (+10%). The subjects with enlarged ovaries had the highest values of LH, testosterone, and androstenedione. Fourteen subjects out of 46 (30%), with normal ovarian volume in the first examination, reg istered an ovarian enlargement in the last examination, exceeding the normal range. Moreover, a change from the homogeneous or multifollicul ar structure to the polycystic one was observed. Twenty-one subjects o ut of 27 (78%) with enlarged ovaries in the first examination confirme d the high ovarian volume and the unchanged structure in the last exam ination, whereas six subjects (22%) showed ovaries within the normal a dult range; the polycystic structure was substantially confirmed. Thes e results indicate the following. 1) Homogeneous, multifollicular, and polycystic ovaries can usually be found in the postmenarcheal period. 2) Enlarged ovaries, polycystic structure, hyperandrogenemia, and hig h LH values are strongly linked, and they are frequent in irregular cy cles even in the absence of signs of hyperandrogenism. These character istics may all persist or in various aggregations become a permanent f eature. 3) Only a few subjects may lose ovarian enlargement and show a change in the polycystic structure; however, they frequently maintain hyperandrogenemia. 4) During the postmenarcheal period, normal ovaria n characteristics may suddenly change, and the ovaries may take on a p olycystic structure and increase in volume. Moreover, some endocrine p arameters may reach pathologic levels.