Revisiting Hormonal profile in PCOS in Adolescents and Young Women
Main Article Content
Abstract
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.
Keywords:
Adolescent, Polycystic Ovarian Syndrome (PCOS), Diagnosis, Prevalence, Body Mass Index (BMI)
Article Details
How to Cite
BERA, Ananya; BAGCHI, Bishista; CHATTERJEE, Siddhartha.
Revisiting Hormonal profile in PCOS in Adolescents and Young Women.
Medical Research Archives, [S.l.], v. 13, n. 4, may 2025.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/6430>. Date accessed: 06 dec. 2025.
doi: https://doi.org/10.18103/mra.v13i4.6430.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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2. Peña AS, Witchel SF, Hoeger KM, Oberfield SE, Vogiatzi MG, Misso M, Garad R, Dabadghao P, Teede H. Adolescent polycystic ovary syndrome according to the international evidence-based guideline. BMC Med. 2020; 18(1): 1-16. doi: 10.1186/s12916-020-01516-x.
3. Apter D. Endocrine and metabolic abnormalities in adolescents with a PCOS-like condition: consequences for adult reproduction. Trends Endocrinol Metab. 1998; 9(2): 58-61. doi: 10.1016/s1043-2760(98)00020-4.
4. Apter D, Bützow T, Laughlin GA, Yen SS. Accelerated 24-hour luteinizing hormone pulsatile activity in adolescent girls with ovarian hyperandrogenism: relevance to the developmental phase of polycystic ovarian syndrome. J Clin Endocrinol Metab. 1994; 79(1): 119-125. doi: 10.1210/jcem.79.1.8027216.
5. Moghetti P, Castello R, Negri C, Tosi F, Spiazzi GG, Brun E, Balducci R, Toscano V, Muggeo M. Insulin infusion amplifies 17 alpha-hydroxycorticosteroid intermediates response to adrenocorticotropin in hyperandrogenic women: apparent relative impairment of 17,20-lyase activity. J Clin Endocrinol Metab. 1996; 81(3): 881-886. doi: 10.1210/jcem.81.3.8772544.
6. Wallach EE, Nobels F, Dewailly D. Puberty and polycystic ovarian syndrome: the insulin/insulin-like growth factor I hypothesis. Fertil Steril. 1992; 58(4): 655-666. doi: 10.1016/s0015-0282(16)55307-2.
7. Ehrmann DA, Schneider DJ, Sobel BE, Cavaghan MK, Imperial J, Rosenfield RL, Polonsky KS. Troglitazone improves defects in insulin action, insulin secretion, ovarian steroidogenesis, and fibrinolysis in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 1997; 82(7): 2108-2116. doi: 10.1210/jcem.82.7.4069.
8. Diamanti-Kandarakis E, Kouli C, Tsianateli T, Bergiele A. Therapeutic effects of metformin on insulin resistance and hyperandrogenism in polycystic ovary syndrome. Eur J Endocrinol. 1998;138(3): 269-274. doi: 10.1530/eje.0.1380269.
9. Haghollahi F, Heidary Z, Bagheri M, Masoumi M, Ghaemi M. Polycystic Ovary Syndrome in Adolescence: From the Cradle to the Grave. Fertil, Gynecol Androl. 2022; 2(1). doi: https://doi.org/10.5812/fga-129248.
10. Rosenfield RL, Ehrmann DA. The Pathogenesis of Polycystic Ovary Syndrome (PCOS): The Hypothesis of PCOS as Functional Ovarian Hyperandrogenism Revisited. Endocr Rev. 2016; 37(5): 467-520. doi: 10.1210/er.2015-1104.
11. Chatterjee S, Chowdhury RG, Ganguly D. Adolescent PCO-The Modern Approach. Journal of Krishna Institute of Medical Sciences (JKIMSU). 2014; 3(2): 160-164.
12. Liu J, Wu Q, Hao Y, Jiao M, Wang X, Jiang S, Han L. Measuring the global disease burden of polycystic ovary syndrome in 194 countries: Global Burden of Disease Study 2017. Hum Reprod. 2021; 36(4): 1108-1119. doi: 10.1093/humrep/deaa371.
13. Vink JM, Sadrzadeh S, Lambalk CB, Boomsma DI. Heritability of polycystic ovary syndrome in a Dutch twin-family study. J Clin Endocrinol Metab. 2006; 91(6): 2100-2104. doi: 10.1210/jc.2005-1494.
14. Nelen WL, Blom HJ, Steegers EA, den Heijer M, Eskes TK. Hyperhomocysteinemia and recurrent early pregnancy loss: a meta-analysis. Fertil Steril. 2000; 74(6): 1196-1199. doi: 10.1016/s0015-0282(00)01595-8.
15. Quéré I, Mercier E, Bellet H, Janbon C, Marès P, Gris JC. Vitamin supplementation and pregnancy outcome in women with recurrent early pregnancy loss and hyperhomocysteinemia. Fertil Steril. 2001; 75(4): 823-825. doi: 10.1016/s0015-0282(01)01678-8.
16. Meczekalski B, Niwczyk O, Kostrzak A, Maciejewska-Jeske M, Bala G, Szeliga A. PCOS in Adolescents-Ongoing Riddles in Diagnosis and Treatment. J Clin Med. 2023; 12(3): 1221. doi: 10.3390/jcm12031221.
17. Gibson-Helm M, Teede H, Dunaif A, Dokras A. Delayed Diagnosis and a Lack of Information Associated With Dissatisfaction in Women With Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2017; 102(2): 604-612. doi: 10.1210/jc.2016-2963.
18. Bonny AE, Appelbaum H, Connor EL, Cromer B, DiVasta A, Gomez-Lobo V, Harel Z, Huppert J, Sucato G; NASPAG Research Committee. Clinical variability in approaches to polycystic ovary syndrome. J Pediatr Adolesc Gynecol. 2012; 25(4): 259-261. doi: 10.1016/j.jpag.2012.03.004.
19. Auble B, Elder D, Gross A, Hillman JB. Differences in the management of adolescents with polycystic ovary syndrome across pediatric specialties. J Pediatr Adolesc Gynecol. 2013; 26(4): 234-238. doi: 10.1016/j.jpag.2013.03.007.
20. Sebastian MR, Wiemann CM, Bacha F, Alston Taylor SJ. Diagnostic Evaluation, Comorbidity Screening, and Treatment of Polycystic Ovary Syndrome in Adolescents in 3 Specialty Clinics. J Pediatr Adolesc Gynecol. 2018; 31(4): 367-371. doi: 10.1016/j.jpag.2018.01.007.
21. Peña AS, Metz M. What is adolescent polycystic ovary syndrome? J Paediatr Child Health. 2018; 54(4): 351-355. doi: 10.1111/jpc.13821.
22. Witchel SF, Oberfield S, Rosenfield RL, Codner E, Bonny A, Ibáñez L, Pena A, Horikawa R, Gomez-Lobo V, Joel D, Tfayli H, Arslanian S, Dabadghao P, Garcia Rudaz C, Lee PA. The Diagnosis of Polycystic Ovary Syndrome during Adolescence. Horm Res Paediatr. 2015; 83 (6): 376-389. doi: 10.1159/000375530.
23. ESHRE TR, ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil steril. 2004; 81(1): 19-25. doi: https://doi.org/10.1016/j.fertnstert.2003.10.004
24. Ibáñez L, Oberfield SE, Witchel S, Auchus RJ, Chang RJ, Codner E, Dabadghao P, Darendeliler F, Elbarbary NS, Gambineri A, Garcia Rudaz C, Hoeger KM, López-Bermejo A, Ong K, Peña AS, Reinehr T, Santoro N, Tena-Sempere M, Tao R, Yildiz BO, Alkhayyat H, Deeb A, Joel D, Horikawa R, de Zegher F, Lee PA. An International Consortium Update: Pathophysiology, Diagnosis, and Treatment of Polycystic Ovarian Syndrome in Adolescence. Horm Res Paediatr. 2017; 88(6): 371-395. doi: 10.1159/000479371.
25. Zawadri J. Diagnostic criteria for polycystic ovary syndrome: towards a rational approach. Polycystic ovary syndrome. Current issues in endocrinology and metabolism. 1992.
26. Azziz R, Carmina E, Dewailly D, Diamanti-Kandarakis E, Escobar-Morreale HF, Futterweit W, Janssen OE, Legro RS, Norman RJ, Taylor AE, Witchel SF; Androgen Excess Society. Positions statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. J Clin Endocrinol Metab. 2006; 91(11): 4237-4245. doi: 10.1210/jc.2006-0178.
27. Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran L, Piltonen T, Norman RJ; International PCOS Network. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Fertil Steril. 2018;110(3): 364-379. doi: 10.1016/j.fertnstert.2018.05.004.
28. Teede H, Deeks A, Moran L. Polycystic ovary syndrome: a complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan. BMC Med. 2010; 8 (1): 41. doi: 10.1186/1741-7015-8-41.
29. Dahlgren E, Janson PO, Johansson S, Lapidus L, Odén A. Polycystic ovary syndrome and risk for myocardial infarction. Evaluated from a risk factor model based on a prospective population study of women. Acta Obstet Gynecol Scand. 1992; 71(8): 599-604. doi: 10.3109/00016349209006227.
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