Prevalence of polycystic ovarian syndrome among adolescents and young women in India

Background: There is little epidemiological data from India on the prevalence of polycystic ovarian syndrome (PCOS). The objectives of the present study were to estimate the prevalence of PCOS using different criteria among adolescents and young women and to evaluate risk factors associated with PCOS. Materials and Methods: A total of 518 participants, adolescents (12-17 years, n = 246) and young women (18-30 years, n = 272), were recruited. Participants who were overweight and having menstrual disorders or biochemical abnormalities were invited for ultrasonographic examination. A standardized questionnaire assessed the regularity of menstrual cycles, body hair growth, skin, body weight, sleep, and androgen excess. The ovarian volume and follicular size were assessed transabdominally. Prevalence of PCOS was assessed by the Rotterdam, AE-PCOS, and NIH criteria. Results: The mean age of participants with PCOS was 19.7 +/- 4.2 years and those without PCOS was 18.4 +/- 4.2 years. Mean body weight, body fat %, body mass index, waist circumference, systolic and diastolic blood pressures, and fasting insulin were significantly higher in the PCOS group. Prevalence of polycystic ovaries on ultrasonography was observed in 78.6% of the women with PCOS as against 5% in women without PCOS. Obesity (odds ratio (OR): 3.09, 95% confidence interval (CI): 1.32-7.21), insulin resistance (OR: 2.12, 95% CI: 1.12-4.0), and hypertension (OR: 4.46, 95% CI: 1.52-13.06) were significantly associated with PCOS (P < 0.05). The overall prevalence of PCOS was highest with 8.1% according to the Rotterdam criteria followed by AE-PCOS (2.9%) and NIH (2.1%). Irrespective of the criterion used, the prevalence increased with age. Conclusion: There is a high prevalence of PCOS in urban India, which emphasizes the need for urgent preventive and control measures. Early diagnosis is therefore crucial in incorporating lifestyle and dietary modifications for weight reduction and better control of blood pressure at a younger age to further prevent long-term reproductive and metabolic disorders.