Abstract
<strong>Objectives: </strong>To evaluate the clinicopathological features of adolescence diagnosed with polycystic ovarian syndrome. <strong>Methods: </strong>This is a descriptive study conducted at the Gynecology Clinics of University Obstetric Unit, Teaching Hospital-Jaffna to evaluate the clinicopathological features of adolescence diagnosed with polycystic ovarian syndrome (PCOS) over a period of 3 years. A total of 56 adolescent girls were diagnosed with PCOS during this period with the currently accepted diagnostic criteria recommended by the Pediatric Endocrine Society and all of them were included in the study. Clinicopathological features at the time of diagnosis of PCOS obtained from medical records were analyzed and descriptive statistics were calculated. <strong> </strong> <strong>Discussion: </strong>Emphasizing the importance of early detection of PCOS in women especially during the adolescent periods, its diagnosis should be based on the presence of clinical and/or biochemical hyperandrogenism and irregular menses for at least 1 year as recommended. Our results suggest that the commonest feature of clinical hyperandrogenism being moderate hirsuitism (89.3%) and the commonest type of abnormal uterine bleeding being oligomenorrhea (54%). An obvious rising trend in the number of diagnosed patients with age was also observed. Though the prevalence anovulatory pattern of bleeding among adolescence diagnosed with PCOS consistent with larger studies in Caucasian population, commonest manifestation of clinical hyperandrogenism was moderate hirsutism which was significantly higher compared to other studies. This could be explained by its variation across ethnicities especially with a higher prevalence of hirsuitism among South Asian population. In the absence of any published data on clinicopathological features of adolescence diagnosed with PCOS in Sri Lanka, our series highlights its pattern at the time of diagnosis.
Highlights
IntroductionPolycystic ovary syndrome (PCOS) affects 6-15% of women of reproductive age and accounts for almost 75% of hyperandrogenism in adults[1].Though the cause of PCOS is unknown, considerable evidence suggests that it is a complex trait arising from heritable influences, nonheritable intra- and extrauterine environmental factors, variations in insulin resistance, alterations in steroidogenesis/steroid metabolism, and alternative adaptations to energy excess[2,3].Its complex interactions generally mimic an autosomal dominant trait with variable penetrance and metabolic syndrome prevalence is high in parents, siblings and correlates in identical twins[4,5].Adult women present with classic features that includes chronic anovulation associated with relative infertility, polycystic ovarian morphology, and hirsutism[6].Diagnostic criteria for adult women have been developed by three international conferences namely National Institutes of Health (NIH) conference criteria (1990), the Rotterdam consensus criteria (2003) and the Androgen Excess-PCOS Society consensus criteria (2006)[7,8].Though they are somewhat different many criterions overlap
Emphasizing the importance of early detection of Polycystic ovary syndrome (PCOS) in women especially during the adolescent period, its diagnosis should be based on the presence of clinical and/or biochemical hyperandrogenism and irregular menses for at least 1 year as recommended
Abnormal uterine bleeding pattern being the first definitive criterion to make a diagnosis of PCOS in adolescence, the combination of oligomenorrhea (54%) and excessive anovulatory bleeding (14%) accounted for 68% in our study which could be categorized as anovulatory type of abnormal bleeding
Summary
Polycystic ovary syndrome (PCOS) affects 6-15% of women of reproductive age and accounts for almost 75% of hyperandrogenism in adults[1].Though the cause of PCOS is unknown, considerable evidence suggests that it is a complex trait arising from heritable influences, nonheritable intra- and extrauterine environmental factors, variations in insulin resistance, alterations in steroidogenesis/steroid metabolism, and alternative adaptations to energy excess[2,3].Its complex interactions generally mimic an autosomal dominant trait with variable penetrance and metabolic syndrome prevalence is high in parents, siblings and correlates in identical twins[4,5].Adult women present with classic features that includes chronic anovulation associated with relative infertility, polycystic ovarian morphology, and hirsutism[6].Diagnostic criteria for adult women have been developed by three international conferences namely National Institutes of Health (NIH) conference criteria (1990), the Rotterdam consensus criteria (2003) and the Androgen Excess-PCOS Society consensus criteria (2006)[7,8].Though they are somewhat different many criterions overlap. Polycystic ovary syndrome (PCOS) affects 6-15% of women of reproductive age and accounts for almost 75% of hyperandrogenism in adults[1]. Diagnostic criteria for adult women have been developed by three international conferences namely National Institutes of Health (NIH) conference criteria (1990), the Rotterdam consensus criteria (2003) and the Androgen Excess-PCOS Society consensus criteria (2006)[7,8]. Though they are somewhat different many criterions overlap. While the first signs of PCOS can be perceptible even during childhood, the unique features of the syndrome in adolescence are not very clear[9]
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