摘要Background Hyperandrogenism represents a prevalent yet diagnostically challenging endocrine condition in adolescents,with polycystic ovary syndrome(PCOS),non-classic congenital adrenal hyperplasia,and androgen-secreting tumors constituting the most common etiologies.The physiological overlap with normal pubertal development creates significant diagnostic complexity,necessitating evidence-based approaches tailored to this unique population.Data sources This narrative review synthesizes evidence from a comprehensive literature search(PubMed/Scopus/Web of Science/EMBASE/Cochrane,2000-2025)evaluating diagnostic and therapeutic approaches for adolescent hyperandrogen-ism.We prioritized clinical practice guidelines(including 2023 international PCOS guidelines),randomized controlled trials,and large cohort studies(n ≥ 50),excluding conference abstracts and non-peer-reviewed sources.Data extraction focused on diagnostic accuracy,treatment efficacy,safety profiles,and quality-of-life outcomes across 122 included studies.Results Current diagnostic frameworks demonstrate critical limitations in adolescent populations,particularly regarding age-specific biochemical cutoffs(testosterone,dehydroepiandrosterone sulphate,and 17-hydroxyprogesterone)and imaging interpretation.While combined oral contraceptives remain first-line therapy,emerging data highlight both metabolic risks(particularly with long-term use)and the potential of insulin sensitizers such as myo-inositol.Psychological comorbidities(anxiety,depression)are prevalent(38％-45％prevalence)yet are frequently under-addressed in clinical management.Key knowledge gaps persist regarding optimal(1)diagnostic thresholds for diverse ethnic groups;(2)longitudinal safety of hormonal therapies;and(3)integrated mental health interventions.Conclusions Adolescent hyperandrogenism demands multidisciplinary management involving endocrinologic,gynecologic,dermatologic,and psychological expertise.Future research must prioritize(1)validated age-and puberty-stage-specific diagnostic criteria;(2)safety/efficacy data for emerging therapies;and(3)standardized protocols for mental health screening.This synthesis provides a framework for evidence-based,individualized care while highlighting urgent research priorities.