24 - Polycystic ovary syndrome in South Asians

Abstract

Polycystic ovary syndrome (PCOS) is the most common endocrinologic condition affecting females in the reproductive age group, with a prevalence estimated at 4% to 25% depending on the diagnostic criteria used. Patients with PCOS demonstrate a combination of characteristics, which may include anovulation, oligo or amenorrhoea, hirsutism, acne, hyperandrogenism, and morphologic changes in the ovary evident on ultrasonography. South Asian is a collective word used to refer to people who originate from the Indian subcontinent (India, Pakistan, Sri Lanka, Bangladesh, and Nepal). These countries are densely populated and, like many regions of the world, also have people who suffer from PCOS. Globally, 20% of the world’s population is South Asian. The 2000 census revealed that there were 1.6 million South Asians living in the United States (0.7%). In 2001, 1 million South Asians were living in Canada (3%), and in 1999, a further 1 million were living in Australia (1.3%). In the United Kingdom (UK), 5.7% of the population of England and Wales identify as Asian or Asian-British. In the UK in 2001, South Asians constituted the largest ethnic minority group at 4% of the population. As a result, it is essential to better understand the impact of PCOS on South Asian females to ensure clinical treatments are well aligned to need. It is a known fact that various regions of the world will display ethnic variations in the expression of the condition. In the UK, in a community-based study, it was found that polycystic ovaries (PCO) were particularly common among females of South Asian origin (52%), compared with the prevalence of PCO observed in a predominantly Caucasian population (22%). A similar community-based study in Sri Lanka found the prevalence of PCOS to be 6.3%. The South Asian population, in general, also exhibits a higher prevalence of insulin resistance and type 2 diabetes, which may increase long-term morbidity among those with PCOS.