Pre‐polycystic ovary syndrome and polymenorrhoea as new facets of polycystic ovary syndrome (PCOS): Evidences from a single centre data set
Mohd Ashraf Ganie, Aafia Rashid, Mohammad Salem Baba, Mohd Afzal Zargar, Imtiyaz Ahmad Wani, Sobia Nisar, Ishfaq Ahmad Wani, Syed Douhath, Mukesh Sriwastawa, Mohd Ishaq Geer, Mir Mohd Asrar, Rintu Kutum, Saqib Hassan, Shahid Khan, Wajid Rafi, Dil Afroz Bhat, Wasia Showkat, Tajali Sahar, Naseer Ahmad Choh, Rabia Khurshid, Syed Mudassar, Zafar Amin Shah, Iram Shabir, Sanjeed Ahmad Sofi, Nandita Gupta, Imran Hafeez, Vishnubatla Sreenivas- Endocrinology, Diabetes and Metabolism
- Endocrinology
Abstract
Objective
Polycystic ovary syndrome (PCOS) is a complex disorder with diverse metabolic implications. Diagnosis typically relies on oligo‐amenorrhoea (OA), hyperandrogenism (HA), and polycystic ovarian morphology (PCOM). However, the role of polymenorrhoea in PCOS remains understudied. Additionally, limited information exists regarding metabolic disturbances in women with partial PCOS phenotypes that do not meet diagnostic criteria. This extensive database aims to provide substantial evidence on the metabolic implications of polymenorrhoea and partial PCOS phenotypes.
Design
Prospective observational study.
Patients and Measurements
In this single‐centre study, 6463 women with PCOS‐like characteristics and 3142 age‐matched healthy women were included. The study compared clinical (anthropometry, modified Ferriman Gallwey [mFG] score), hormonal (serum testosterone), and metabolic (plasma glucose, serum lipids, insulin) characteristics between women diagnosed with PCOS, those with partial PCOS phenotypes, and the healthy control group
Results
In all, 5174 women met Rotterdam criteria for PCOS diagnosis, while 737 were classified as Pre‐PCOS, including HA (n = 538), OA (n = 121), or PCOM (n = 78). Common clinical features included oligomenorrhoea (75.5%), hirsutism (82.9%), obesity (27.2%), hypertension (1.6%), metabolic syndrome (19.6%), and diabetes mellitus (5.6%). Women diagnosed with PCOS, HA only, and OA only exhibited higher average body mass index, plasma glucose levels (both fasting and 2 h after the oral glucose tolerance test), and lipid fractions in comparison to those with PCOM and the healthy controls. However, indices of insulin resistance were similar among women with PCOS, HA, PCOM, and OA, albeit higher than in the healthy controls. The polymenorrhoea subgroup (5.9%) had lower BMI and serum testosterone, but similar mFG score, plasma glucose, insulin, and lipid levels as the oligomenorrhoea subgroup.
Conclusion
The metabolic disturbances observed in Pre‐PCOS women highlight the need to reassess diagnostic criteria. Including the polymenorrhoea subcategory in PCOS criteria is recommended due to similar metabolic dysfunctions as the oligomenorrhoea group.