Abstract
BackgroundThere is no clear and contemporaneous method for screening of idiopathic hirsutism (IH) and polycystic ovary syndrome (PCOS) at the community level and current estimates regarding their prevalence are limited. We aimed to ascertain the prevalence of IH and PCOS in a randomly selected sample of reproductive aged female participants of the Tehran Lipid and Glucose Study (TLGS).MethodsOne thousand and two women, aged 18-45 years, were randomly selected from among reproductive aged women who participated in the TLGS. Those women with either hirsutism or menstrual dysfunction were assessed for biochemical hyperandrogenemia; whereas those participants with hirsutism per se were further assessed for subclinical menstrual dysfunction. PCOS were diagnosed using the National Institute of Health (NIH) criteria. IH was defined as hirsutism without clinical or sub clinical menstrual dysfunction or biochemical hyperandrogenemia (BH).ResultsThe mean ± SD of age of study population was 29.2 ± 8.7 years. Estimated prevalences of idiopathic hirsutism and pure menstrual dysfunction were 13.0% (95% CI: 10.9%-15.1%) and 1.5%(95% CI: 1.1%-1.9%), respectively. The prevalence of PCOS was 8.5% (95% CI: 6.8% - 10.2%); more than one third of these cases would possibly have remained undiagnosed or misdiagnosed, had we not assessed them for subclinical menstrual dysfunction or biochemical hyperandrogenemia.ConclusionsThese data from a large representative and non selected population of women confirm the concept that IH and PCOS are the two most common gynecological endocrinopathies among reproductive aged women. The estimated prevalence of these conditions is highly influenced by their screening methods at the community level.
Highlights
There is no clear and contemporaneous method for screening of idiopathic hirsutism (IH) and polycystic ovary syndrome (PCOS) at the community level and current estimates regarding their prevalence are limited
Ethnic and racial variations strongly affect the clinical presentation of PCOS and IH [24,25,26,27]; the wide ranges of prevalence of these disorders can be further explained by differences in the recruitment process of the study population, controversy regarding its diagnostic criteria and the method used to define each criteria
We aimed to identify the prevalence and clinical characteristics of PCOS and IH among a non-selected sample of reproductive aged women who participated in the Tehran Lipid and Glucose Study (TLGS)
Summary
There is no clear and contemporaneous method for screening of idiopathic hirsutism (IH) and polycystic ovary syndrome (PCOS) at the community level and current estimates regarding their prevalence are limited. PCOS is a heterogeneous disorder and its influence on reproductive capability and metabolic disturbances including insulin resistance, type 2 diabetes mellitus, dyslipidemia and cardiovascular diseases is varied, according to its diagnostic criteria, race and recruitment of study subjects [18,19,20,21,22]; the metabolic and cardiovascular complications of IH have not been appropriately described [1,23]. Ethnic and racial variations strongly affect the clinical presentation of PCOS and IH [24,25,26,27]; the wide ranges of prevalence of these disorders can be further explained by differences in the recruitment process of the study population, controversy regarding its diagnostic criteria and the method used to define each criteria. The type of participants in each epidemiological study may potentially bias the result [12]; using the Rotterdam (Rott.) versus the NIH criteria, increases the PCOS prevalence by 1.5-2 times and undoubtedly this reduces the prevalence of IH [5,28,29,30].
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