The burden of the probable polycystic ovarian syndrome and its associated factor among college going late adolescents and young adults: a cross sectional analytical study in urban Puducherry, South India

Prevalence, risk factors and health-seeking behavior of menstrual disorders among women in India: a review of two-decade evidence

BACKGROUND

Menstrual health is critical for women of reproductive age. It is also evident that menstrual disorders have contributed to the increasing burden of non-communicable diseases.

OBJECTIVE

To our knowledge, no literature review explicitly addresses the prevalence, risk factors, and health-seeking behaviour of menstrual disorders in India. Therefore, the current study aims to synthesize the available scientific evidence on the prevalence and risk factors of menstrual disorders in India over the last two decades.

METHODS

We followed PRISMA guidelines to conduct the review. We used Google Scholar, PubMed, JSTOR, Scopus, and Sci Direct search engines to find eligible research studies and extracted data from 2000 to 2022. We also conducted quality appraisals of included studies in the review.

RESULTS

Results show that the prevalence of any menstrual disorders ranges from 3% to 87%. Among all menstrual disorders, Dysmenorrhea was reported to be high (46% to 76%) among women, followed by premenstrual symptoms (PMS) (40% to 71%), while PCOS (3% to 14.14%) was less. The study further found that irregular lifestyle, obesity, inadequate diet, age at marriage, family history, smoking, and place of residence factors is associated with menstrual disorders in India. As far as health-seeking for menstrual disorders is concerned, one-third of women sought treatment for menstrual disorders.

CONCLUSION

The present study has revealed that most women reported high rates of Dysmenorrhea, while Polycystic Ovary Syndrome (PCOS) is less prevalent. The study findings suggest that health-seeking behaviour is the most important factor in reducing menstrual disorders, which has long-term effects of increasing other comorbidities.

Normative Data for Modified Ferriman-Gallwey Score and the Prevalence of Hirsutism in Young South Indians

Introduction

The modified Ferriman-Gallwey score (mFGS) cut-offs to define hirsutism vary with ethnicity, whereas no such cut-offs are established for Indian women. Well-conducted studies that report the prevalence of hirsutism in Indian women are limited. Hence, this study was conducted to report the prevalence of hirsutism and population-specific cut-offs for mFGS in South-Indian women.

Methods

In this cross-sectional, community-based study, adult women in reproductive age (18-40 years) were screened for hirsutism by two trained medical students. Hirsutism was assessed using the mFGS and case record file.

Results

A total of 453 women were included in the study [age: 22.15 ± 5.27 years; body mass index (BMI): 22.5 ± 3.58 kg/m2]. The median (IQR) mFGS was 1(0-3); only eight participants (1.8%) had mFGS ≥8, and all these eight women had at least another PCOS-related feature (irregular menstrual cycles and/or topical therapy-resistant acne). The median (IQR) mFGS in the PCOS phenotype group (n = 52), non-PCOS-phenotype group (n = 401), non-obese group (<25 kg/m2), non-PCOS-phenotype group (n = 322), obese group (≥ 25 kg/m2), non-PCOS-phenotype group (n = 79), overweight group (BMI: 23-25 kg/m2), non-PCOS-phenotype group (n = 74), normal BMI group (<23 kg/m2), and non-PCOS-phenotype group (n = 248) were 4 (1-6), 1 (0-2), 1 (0-2), 2 (1-3), 1 (0-2), and 1 (0-2), respectively. The 97.5th centile mFGS in all groups except the PCOS phenotype group and the obese and non-PCOS phenotype groups was 5.

Conclusion

We propose a new mFGS cut-off of 5 in the South-Indian population for evaluation of hirsutism, and the prevalence rates of hirsutism in the South-Indian population were 1.8% and 9.9% using mFGS of ≥8 and ≥5 to define hirsutism, respectively.

Comparison of Clinical, Biochemical, and Sonological Parameters in Adolescents with and without Polycystic Ovarian Syndrome

Objectives The Pediatric Endocrine Society consensus criteria was developed in 2015 to diagnose adolescent PCOS. There are no Indian studies that use these criteria for diagnosis and then compare the clinical characteristics with those of normal controls. The objective of this study was to compare the clinical and biochemical profile in adolescents with and without PCOS and to study the ovarian morphology in adolescents with and without PCOS.

Materials and Methods We conducted a prospective case–control study on 60 adolescents who attended the outpatient department/adolescent immunization clinic. Group A included 30 adolescent girls with PCOS diagnosed as per the consensus criteria and Group B included 30 adolescents without PCOS. All participants were clinically evaluated and called empty stomach in the follicular phase for metabolic (Serum TSH, prolactin, FSH, LH, and testosterone) and endocrinal workup (2-hour OGTT, lipid profile) followed by ultrasonic examination.

Results In group A, 40% were overweight and 36.7% were obese and in group B, 20% were overweight and 20% were obese. There were no significant differences noted in gonadotropin levels in two groups. Mean testosterone levels were higher in PCO adolescents. The mean ovarian volume and ovarian follicle number were significantly higher in adolescents with PCOS. We found that if ultrasound criteria were added to the diagnosis, there would be about 7% lesser PCOS diagnosis.

Conclusion PCOS alters the fat distribution and lipid distribution in the body. These are features that lead to long-term metabolic alterations and life-threatening diseases. All PCOS adolescents thus be screened for these abnormalities and advised lifestyle modifications to keep these parameters under control.

Polycystic Ovarian Syndrome roots needs to be rooted out at the outset: Will early screening help?

  doi: https://doi.org/10.12669/pjms.37.5.4509 How to cite this:Khan SH, Urooj U. Polycystic Ovarian Syndrome roots needs to be rooted out at the outset: Will early screening help? Pak J Med Sci. 2021;37(5):1254-1255. doi: https://doi.org/10.12669/pjms.37.5.4509 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.