Abstract
BackgroundPolycystic ovary syndrome (PCOS) is a common condition in women of reproductive age. It is characterized by hyperandrogenism, oligomenorrhea/amenorrhea and polycystic ovaries. It is associated with obesity, diabetes, dyslipidemia and cardiovascular disease. No studies have been conducted on the prevalence of PCOS in Brazilian or South American women. Few studies using the Rotterdam criteria have been published. The objective of the present study was to calculate the prevalence of PCOS at primary healthcare level in Salvador, Brazil based on these criteria.MethodsThis was a cross-sectional, two-phase study conducted in a probability sample of women of 18–45 years of age screened for cervical cancer in the primary healthcare network of the city of Salvador, Brazil. In the first phase, interviews were conducted, weight, height, waist circumference, blood pressure and random blood sugar levels were measured, and the presence of acne and hirsutism was investigated. Women with at least one diagnostic criterion were referred for the second phase, which consisted of specialist consultation, pelvic ultrasonography and hormone measurements for differential diagnosis and/or investigation of a second criterion.ResultsOf the 859 women interviewed, 88.5% were black and 58.7% had 11 years of schooling or less. A diagnosis of PCOS was excluded in 84.4%, undetermined in 7.1% and confirmed in 8.5% (95%CI: 6.80–10.56). There were no statistically significant differences between these three groups with respect to weight, body mass index, waist circumference, blood sugar levels or arterial blood pressure. Women with PCOS were younger (p = 0.00), taller (p = 0.04), had fewer children (p = 0.00), were better educated (p = 0.01), and had higher total testosterone levels (p = 0.01) and a higher LH/FSH ratio (p = 0.01).ConclusionAccording to the Rotterdam criteria, the prevalence of PCOS in women seeking primary healthcare in Salvador, Brazil, was 8.5%.
Highlights
Polycystic ovary syndrome (PCOS) is a common condition in women of reproductive age
PCOS is a hyperinsulinemic syndrome strongly associated with obesity and type 2 diabetes mellitus and has been associated with high blood pressure, dyslipidemia and cardiovascular disease [2]
In 1990, the National Institutes of Health (NIH) established that a diagnosis of PCOS required the simultaneous presence of two clinical criteria: oligoovulation or anovulation and clinical and/or biochemical hyperandrogenism, after all other possible etiologies had been excluded
Summary
Polycystic ovary syndrome (PCOS) is a common condition in women of reproductive age. It is characterized by hyperandrogenism, oligomenorrhea/amenorrhea and polycystic ovaries. It is associated with obesity, diabetes, dyslipidemia and cardiovascular disease. Polycystic ovary syndrome (PCOS) is characterized by anovulation, hyperandrogenic symptoms and infertility [1,2,3]. In 2003, the Rotterdam Consensus (RC), sponsored by the European Society for Human Reproduction and Embryology and the American Society for Reproductive Medicine, stipulated that at least two of the following three criteria should be present: oligoovulation or anovulation, clinical and/or biochemical hyperandrogenism and ultrasonographically detected polycystic ovaries, after the exclusion of all other possible etiologies [11]. The presence of some of the relevant clinical aspects or all of them appears to be related to a greater or lesser degree to insulin resistance and to the metabolic syndrome [13,14], which may determine prognosis
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