George Creatsas

Primary care physicians are frequently faced with the challenge of evaluating primary amenorrhea in adolescent girls. Approximately 15% of these women have abnormal genital examination, with Müllerian agenesis being the second most frequent cause. We report two cases of adolescents with Müllerian agenesis that presented to a tertiary adolescent medicine center with primary amenorrhea and the very rare sexual phenomenon of urethral coitus. The aim of this report is to emphasize the importance of performing a genital examination in girls who present with amenorrhea in the primary care setting, even if ‘normal’ vaginal sexual activity is assumed.

As polycystic ovarian syndrome is among the most common endocrinologic disorders during adolescence, there is always a need to investigate all new relevant data. The present review article, is occupied with - apart from basic knowledge on polycystic ovarian syndrome - issues concerning genetics, new trends in diagnosis, and data on metabolic and endocrine features of the syndrome. Finally, emphasis is given to current therapeutic trends. Early recognition and prompt treatment of polycystic ovarian syndrome in adolescents is important to prevent long-term sequellae. More research is necessary in order to find answers to many clinical and theoretical aspects of the syndrome.