Exp Clin Endocrinol Diabetes 2011; 119(6): 334-337
DOI: 10.1055/s-0030-1269882
Article

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

“Menstrual Irregularities in PCOS. Does it Matter when it Starts?”

S. Livadas1 , M. Christou2 , F. Economou1 , A. Karachalios2 , X. Xyrafis2 , G. Boutzios2 , A. Zerva2 , E. Tantalaki2 , S. Palimeri2 , E. Diamanti-Kandarakis1
  • 1Third Department of Medicine, Endocrine Section, University of Athens Medical School, Athens, Greece
  • 2First Department of Medicine, Endocrine Section, University of Athens Medical School, Athens, Greece
Further Information

Publication History

received 20.04.2010 first decision 11.10.2010

accepted 23.11.2010

Publication Date:
06 May 2011 (online)

Abstract

Background: PCOS is presented by a broad spectrum of menstrual irregularities appearing often at puberty or later on during the reproductive years in women suffering from this multifaceted syndrome. To our knowledge, there is no evidence to suggest whether the time of onset of menstrual irregularities (peri or post pubertal) indicates a differential metabolic and/or hormonal profile as well as ovarian ultrasonographic findings, in adulthood in women with PCOS.

Aim of the study: To compare anthropometric, hormonal-metabolic profile and ultrasound findings in PCOS women with peripubertal onset of menstrual disorders with the corresponding data obtained from PCOS patients with post pubertal onset of menstrual irregularities, matched for BMI and age.

Patients-Methods: 89 PCOS women were evaluated cross-sectionally at the age of 25 years. In 49 subjects menstrual irregularities were present from menarche, whereas in 40 women the irregularities appeared at least 3 years post menarche.

Results: Anthropometric parameters were comparable between the 2 groups. The 2 groups did not differ on metabolic and hormonal profile as well as ovarian ultrasound findings.

Conclusions: These data indicate that the timing of menstrual irregularities, do not appear to have an impact, on hormonal/metabolic profile and ovarian ultrasound morphology in patients diagnosed with PCOS, later in life.

References

  • 1 Apter D, Vihko R. Endocrine determinants of fertility: serum androgen concentrations during follow-up of adolescents into the third decade of life.  J Clin Endocrinol Metab. 1990;  71 970-974
  • 2 Apter D, Butzow T, Laughlin A. et al . Metabolic features of polycystic ovary syndrome are found in adolescent girls with hyperandrogenism.  J Clin Endocrinol Metab. 1995;  80 2966-2973
  • 3 Avvad CK, Holeuwerger R, Silva CVG. et al . Menstrual irregularity in the first postmenarchal years: an early clinical sign of polycystic ovary syndrome in adolescence.  Gynecol Endocrinol. 2001;  15 170-177
  • 4 Azziz R, Carmina E, Dewailly D. et al . Androgen Excess Society. Positions statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline.  J Clin Endocrinol Metab. 2006;  91 4237-4245
  • 5 Balen AH, Conway GS, Kaltsas G. et al . Polycystic ovary syndrome: the spectrum of the disorder in 1741 patients.  Hum Reprod. 1995;  10 2107-2111
  • 6 Diamanti-Kandarakis E, Kouli CR, Bergiele AT. et al . A survey of the polycystic ovary syndrome in the Greek island of Lesbos: hormonal and metabolic profile.  J Clin Endocrinol Metab. 1999;  84 4006-4011
  • 7 Diamanti-Kandarakis E, Christakou C, Palioura E. et al . Does polycystic ovary syndrome start in childhood?.  Pediatr Endocrinol Rev. 2008;  5 904-911
  • 8 Diamanti-Kandarakis E. Polycystic ovarian syndrome: pathophysiology, molecular aspects and clinical implications.  Expert Rev Mol Med. 2008;  10 e3
  • 9 Diamanti-Kandarakis E, Piouka A, Livadas S. et al . Anti-mullerian hormone is associated with advanced glycosylated end products in lean women with polycystic ovary syndrome.  Eur J Endocrinol. 2009;  160 847-853
  • 10 Knochenhauer ES, Key TJ, Kahsar-Miller M. et al . Prevalence of the polycystic ovary syndrome in unselected black and white women of the southeastern United States: a prospective study.  J Clin Endocrinol Metab. 1998;  83 3078-3082
  • 11 Legro RS. Polycystic ovary syndrome and cardiovascular disease: a premature association?.  Endocr Rev. 2003;  24 302-312
  • 12 Littlejohn E, Weiss R, Deplewski D. et al . Intractable early childhood obesity as the initial sign of insulin resistant hyperinsulinism and precursor of polycystic ovary syndrome.  J Pediatr Endocrinol Metab. 2007;  20 41-51
  • 13 Rotterdam Consensus . Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS).  Human Reproduction. 2004;  19 41-47
  • 14 Shaw LJ, Bairey Merz CN, Azziz R. et al . Postmenopausal women with a history of irregular menses and elevated androgen measurements at high risk for worsening cardiovascular event-free survival: results from the National Institutes of Health–National Heart, Lung, and Blood Institute sponsored Women's Ischemia Syndrome Evaluation.  J Clin Endocrinol Metab. 2008;  93 1276-1284
  • 15 Siegberg R, Nilsson CG, Stenman UH. et al . Endocrinologic features of oligomenorrheic adolescent girls.  Fertil Steril. 1986;  46 852-857
  • 16 Solomon CG, Hu FB, Dunaif A. et al . Long or highly irregular menstrual cycles as a marker for risk of type 2 diabetes mellitus.  JAMA. 2001;  286 2421-2242
  • 17 Solomon CG, Hu FB, Dunaif A. et al . Menstrual cycle irregularity and risk for future cardiovascular disease.  J Clin Endocrinol Metab. 2002;  87 2013-2017
  • 18 Van Hoff MH, Voorhorst FJ, Kaptein MB. et al . Endocrine features of polycystic ovary syndrome in a random population sample of 14–16 years old adolescence.  Human Reproduction. 1999;  14 2223-2239
  • 19 Van Hoff MH, Voorhorst FJ, Kaptein MB. et al . Polycystic ovaries in adolescents and the relationships with menstrual cycle patterns, lutenizing hormone, androgens, and isulin.  Fertil Steril. 2000;  74 49-58
  • 20 van Hooff MH, Voorhorst FJ, Kaptein MB. et al . Predictive value of menstrual cycle pattern, body mass index, hormone levels and polycystic ovaries at age 15 years for oligo-amenorrhoea at age 18 years.  Hum Reprod. 2004;  19 383-392
  • 21 Venturoli S, Porcu E, Fabbri R. et al . Longitudinal evaluation of the different gonadotropin pulsatile patterns in anovulatory cycles of young girls.  J Clin Endocrinol Metab. 1992;  74 836-841
  • 22 Zawadski JK, Dunaif A. Diagnostic criteria for polycystic ovary syndrome: toward a rational approach. In: Dunaif A, Givens JR, Haseltine FP, Merriam GR, eds. Polycystic ovary syndrome Boston: Blackwell Scientific Publications; 1992: 377-384

Correspondence

S. Livadas

Third Department of Medicine

Endocrine Section

University of Athens Medical

School

Ermou 6

10563 Athens

Greece

Phone: +30/210/325 0745

Fax: +30/210/325 0790

Email: sarntis@gmail.com

    >