Study of clinical characteristics of women with polycystic ovarian syndrome
Keywords:Acanthosis Nigricans, Hirsuitism, Polycystic ovarian syndrome
Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrinal disorders of the reproductive age group causing anovulation, infertility incidence being 8.7-17.8%. It is associated with obesity, insulin resistance, dyslipidaemia and metabolic syndrome. This study was aimed to study the different clinical characteristics of women diagnosed with PCOS, attending a tertiary care hospital outpatient department.
Methods: This was a hospital-based cross-sectional observational study of 200 patients with PCOS meeting the revised Rotterdam criteria from January 2018-June 2019 excluding pregnant and women with other systemic disorders. A detailed history and examination done, data collected regarding menstrual complaints, features of hyperandrogenism, hirsutism, acne, oily skin and Acanthosis Nigricans (AN) was documented. All data were statistically analyzed and compared using the chi-square or fissures’ exact test. p-value <0.05 considered significant.
Results: A total of 200 patients with PCOS were included in the study, of which 41% were obese, 18% lean. The mean age was 24.44±5.62 years. Menstrual complaints were present in 88% -oligomenorrhea (49%) being the most common. 59% had hirsutism,38% of severe grade. Acanthosis nigricans was present in 33% of the patients. Correlation between hirsutism and alopecia, waist to hip ratio (WHR); acanthosis and WHR were statistically significant.
Conclusions: PCOS is an ill-defined symptom complex where ethnicity plays a vital role, hence creating a greater need to know the characteristics of the syndrome in different populations and ethnicity. All women presenting with oligomenorrhea or other menstrual complaint should be investigated for PCOS and treated accordingly. The syndrome usually occurs with multiple characters. Though obesity is common in PCOS, non-obese are also at risk. The prevalence of AN and Hirsutism in PCOS were comparable. This mandates a need to increase awareness regarding the syndrome in the general population.
Stein IF, Leventhal ML. Amenorrhea associated with bilateral polycystic ovaries. Am J Obstet Gynecol. 1935;29:181.
Achard C, Thiers J. Le virilisme pilaire et son association a l'insuffisance glycolytique (diabete des femmes a barbe). Bull Acad Natl Med. 1921;86(29):51-66.
Ramanand SJ, Ghongane BB, Ramanand JB, Patwardhan MH, Ghanghas RR, Jain SS. Clinical characteristics of polycystic ovary syndrome in Indian women. Indian J Endocrinol Metab. 2013;17(1):138-45.
Andrade VHLD, Mata AMOFD, Borges RS, Costa-Silva DR, Martins LM, Ferreira PMP, et al. Current aspects of polycystic ovary syndrome: A literature review. Rev Assoc Médica Bras. 2016;62(9):867-71.
Nidhi R, Padmalata V, Nagarathna R, Amritanshu R. Prevalence of polycystic ovarian syndrome in Indian adolescents. J Pediatr Adolesc Gynecol. 2011;24:223-7.
Norman RJ, Mahabeer S, Masters S. Ethnic differences in insulin and glucose response to glucose between white and Indian women with polycystic ovary syndrome. Fertil Steril. 1995;63:58-62.
Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19-25.
Guideline - Monash Centre for Health Research and Implementation (MCHRI). Available at: https://www.monash.edu/medicine/sphpm/mchri/pcos/guideline. Accessed on 17th October 2019.
Bode DV, Seehusen DA, Baird DC. Hirsutism in Women. Am Fam Physician. 2012;85(4):373-80.
Misra A, Shrivastava U. Obesity and dyslipidemia in South Asians. Nutr. 2013;5(7):2708-33.
Bajaj HS, Pereira MA, Anjana RM, Deepa R, Mohan V, Mueller NT, et al. Comparison of relative waist circumference between Asian Indian and US adults. J Obes. 2014;2014:461956.
Snehalatha C, Viswanathan V, Ramachandran A. Cutoff values for normal anthropometric variables in Asian Indian adults. Diabetes Care. 2003;26(5):1380-4.
Tabassum K. Ultrasonographic prevalence of polycystic ovarian syndrome in different age groups. Indian J Clin Pract. 2014;25(6):561-4.
Melo AS, Ferriani RA, Navarro PA. Treatment of infertility in women with polycystic ovary syndrome: approach to clinical practice. Clin. 2015;70(11):765-9.
Joham AE, Teede HJ, Ranasinha S, Zoungas S, Boyle J. Prevalence of infertility and use of fertility treatment in women with polycystic ovary syndrome: data from a large community-based cohort study. J Womens Health. 2015;24(4):299-307.
Kalra A, Nair S, Rai L. Association of obesity and insulin resistance with dyslipidemia in Indian women with polycystic ovarian syndrome. Indian J Med Sci. 2006;60:447-53.
Majumdar A, Singh TA. Comparison of clinical features and health manifestations in lean vs. obese Indian women with polycystic ovarian syndrome. J Hum Reprod Sci. 2009;2:12-7.
Schmidt TH, Khanijow K, Cedars MI, Huddleston H, Pasch L, Wang ET, et al. Cutaneous findings and systemic associations in women with polycystic ovary syndrome. JAMA Dermatol. 2016;152(4):391-8.