Prevalence of Polycystic Ovary Syndrome Phenotypes Using Updated Criteria for Polycystic Ovarian Morphology: An Assessment of Over 100 Consecutive Women Self-reporting Features of Polycystic Ovary Syndrome

Abstract

The prevalence of polycystic ovary syndrome (PCOS) and its distinct clinical phenotypes were assessed using 3 sets of international diagnostic criteria in women self-reporting concerns over outward features of PCOS. Revised ultrasonographic criteria for polycystic ovaries (PCO) based on modern ultrasound technology were used. Of the participants, 53%, 62%, and 70% were diagnosed with PCOS using National Institutes of Health, Androgen Excess and PCOS Society, and Rotterdam criteria, respectively. Prevalence of Frank, Ovulatory, Normoandrogenic, and Non-PCO PCOS were 66%, 13%, 11%, and 9%, respectively. Frank PCOS was associated with the severest metabolic disturbances whereas metabolic profiles in Normoandrogenic PCOS did not differ from controls, supporting reduced health risks in women without androgen excess. Metabolic disturbances and hyperandrogenism were linked to excess adiposity across all the groups. Using updated criteria for PCO, the prevalence of Non-PCO PCOS and PCO alone in healthy women recruited from the general population was reduced compared to the previous reports.

Keywords: hirsutism; hyperandrogenism; phenotypes; polycystic ovary syndrome; ultrasonography.

Figure 1.

Classification of participants using NIH, Rotterdam, and AE-PCOS Society guidelines for PCOS. One hundred and twenty-six women self-reporting features of PCOS were evaluated. According to the NIH criteria, 67 (53%) women met the criteria for PCOS and 2 PCOS phenotypes were recognized (A). Eighty-eight (70%) women met the Rotterdam criteria for PCOS and 4 PCOS phenotypes were recognized (B). The AE-PCOS Soceity criteria identified 78 (62%) women meeting the criteria for PCOS and 3 phenotypes were recognized (C). Of the 42 women who presented as healthy controls, 35 met the inclusion criteria for controls while the remaining participants had idiopathic hirsutism, PCO alone, Ovulatory PCOS, or failed to complete the study (D). AE-PCOS indicates Androgen Excess and PCOS; NIH, National Institute of Health; PCOS, polycystic ovary syndrome.