Revisiting Hormonal profile in PCOS in Adolescents and Young Women

Background: Polycystic ovarian Syndrome (PCOS) is a prevalent endocrine condition affecting women of reproductive age. The fundamental reason for the daily rise in the incidence of PCOS in adolescence is inappropriate lifestyle choices. Diagnosing PCOS in adolescent (aged 13-19 years, post 2 years of menarche) and young women (aged 20- 25years) might be difficult due to the rapid physiological and anatomical changes accompanying puberty. It's critical to be aware of the physiological quirks of puberty, which frequently resemble PCOS symptoms. There is a clustering of cardiovascular risk factors in women with PCOS, including hypertension, dyslipidaemia, obesity, and impaired glucose tolerance (IGT). The objective of the present study was to identify the most prevalent hormone in patients with single or multiple hormone disorders related to PCOS in adolescent and young women; after diagnosing them using the Rotterdam criteria This may help to evaluate the associated risks and to plan the treatment protocol.

Methods: In the last few years from October 2022 to October 2024, a total of 6,006 gynecological patients attended Calcutta Fertility Mission, 21 Bondel Road, Kolkata, West Bengal, India. Of these, 2492 were adolescent and young women; 250 of them were diagnosed with PCOS using Rotterdam Criteria. Standardized methods were used to collect anthropometric measures, including weight and height. Serum insulin, Testosterone, Dehydroepiandrosterone (DHEA), Thyroid Stimulating Hormone (TSH), Prolactin (PRL) and Homocysteine (HCY) were measured. Participants with menstrual disorders or any biochemical abnormalities were invited for ultrasonography (USG) examination. The ovarian volume and follicular size were evaluated transabdominally. Follicle stimulating Hormone (FSH), Leutinising Hormone (LH) and Anti Mullerian Hormone (AMH) were not estimated as their dysfunction is well understood. The hormones investigated influences the planning of treatment.

Results: Hyperhomocysteinemia was detected in 52.8% of cases of 250 PCOS patients whereas hyperadrenalism (4.8% in 250 PCOS patients) and hyperprolactinemia with hypothyroidism (4.8% in 250 PCOS patients) were detected in less number of patients.

Conclusion: Complications can be avoided with early detection of adolescent PCO. Early diagnosis and treatment facilitate the easy and successful stabilization of the condition for a longer duration.