Polycystic Ovarian Syndrome in Perimenopausal Women: A Pilot Study

Abstract

Background: Polycystic Ovarian Syndrome (PCOS), characterized by hyperandrogenism, chronic anovulation with polycystic ovaries, probably most common endocrine disorder, can occur at any age, with risks for metabolic/ cardiovascular disorders in future. Objective: Present pilot study was done to know incidence of PCOS among perimenopausal women with menstrual abnormalities and associated abnormalities. Material methods: Study was done at a rural institute in women of 35 to 54 years with menstrual disturbances, with or without obesity, with or without hirsutism. PCOS diagnosed as per criteria of PCOS Consensus Workshop Group (2004) and correlation with socio-economic status, lifestyle, family history, Body Mass Index, co-existing disorders was studied. Results: Twelve perimenopausal of 100 studied were diagnosed to have PCOS after clinical, sonographic, biochemical evaluation, two had hyperprolactinemia, 2 hypothyroidism. Of 12 women eight had leiomyoma uteri. They underwent hysterectomy. Endometrial, histopathology revealed cystic glandular hyperplasia without atypia in 3, atypia in one, proliferative endometrium in two. Two had atrophic endometrium. In all ovarian histopathology revealed multiple cystic ovaries with surrounding hyperthecosis typical of PCOS. Of 12 women, 8 had low fasting glucose/insulin ratio, 5 elevated LH/FSH ratio, 4 elevated free testosterone. Of 88 women with no PCOS, 3 had elevated free testosterone, 21 low fasting glucose/insulin ratio, none had deranged LH/FSH ratio. T3, T4 were elevated in two, low TSH in 2. All PCOS had metabolic disorders, 4 diabetes mellitus, 3 hypertension, 2 diabetes and hypertension, 2 hyperlipidemia with diabetes, hypertension, one (8.33%) hypothyroidism and one (8.33%) had hypertension with hypothyroidism. Conclusion: PCOS in perimenopausal is complex. Studies are needed about de novo, PCOS and follow up of young women with PCOS through menopause. [Condensed Abstract: Polycystic Ovarian Syndrome, can occur at any age with metabolic/cardiovascular risk. Present study was to know incidence of PCOS among 100 women of 35 to 54 years with menstrual disturbances, with or without, obesity, hirsutism. Twelve were diagnosed to have PCOS after clinical, sonographic, biochemical, evaluation, 8 had low fasting glucose/insulin ratio, 5 elevated LH/FSH ratio, 4 elevated free testosterone. All had metabolic disorders, 4 diabetes mellitus, 3 hypertension, 2 diabetes hypertension, 2 hyperlipidemia diabetes, hypertension, one hypothyroidism, one hypertension with hypothyroidism. Studies are needed about de novo, PCOS, follow up of young PCOS women through menopause]