Publication:

Frequency and clinical profile of polycystic ovary syndrome among young Indian women presenting with menstrual irregularities: a hospital-based cross-sectional study

Background Polycystic ovary syndrome (PCOS) is a highly prevalent reproductive endocrinopathy. Diagnosing PCOS in adolescents and young adults presents major challenges due to physiological overlaps with normal pubertal development. This study aimed to determine the clinical frequency of PCOS among young women (15–24 years) presenting with menstrual irregularities at a tertiary care hospital in South India, and to characterize their anthropometric, clinical, and biochemical profiles.

Methods This hospital-based cross-sectional study evaluated 180 young women (15–24 years) presenting with menstrual irregularities over a 12-month period. Participants were stratified into adolescents (15–19 years; diagnosed via international evidence-based guidelines) and young adults (20–24 years; diagnosed via modified Rotterdam criteria). Clinical parameters, hormone profiles, and transabdominal pelvic ultrasound metrics were recorded.

Results Among 180 symptomatic participants, 114 met age-specific criteria for PCOS, yielding a clinical frequency of 63.3% within this cohort. Within the PCOS arm, 40.4% (n =46) were adolescents and 59.6% (n=68) were young adults. Clinical hyperandrogenism was highly prominent (hirsutism: 48.9%; acne: 36.7%), starkly outstripping biochemical hyperandrogenaemia (5.0%). Statistically significant differences were identified between the PCOS and non-PCOS cohorts regarding mean age ( 20.66±1.82 vs.19.91±2.02 years, p=0.014)), mean BMI (24.17±5.67 vs. 22.20±3.58kg/m2, p=0.020), mean luteinizing hormone (9.38±4.21 vs 8.24±3.11IU/l, p = 0.041), and mean thyroid stimulating hormone levels (2.78±2.51 vs. 2.23±1.41mIU/l, p=0.040 ).

Conclusions PCOS is the primary driver of menstrual irregularities in young seeking-care populations in this demographic. The divergence between prominent clinical hyperandrogenism and low biochemical hyperandrogenaemia emphasizes the clinical reliance on standardized physical evaluations over routine biochemical assays for effective early screening.