THE IMPACT OF VARIATIONS IN DIAGNOSTIC CRITERIA FOR ADOLESCENT POLYCYSTIC OVARY SYNDROME (PCOS), EXCLUDING POLYCYSTIC OVARIAN MORPHOLOGY, ON DIAGNOSIS AND TREATMENT APPROACHES IN PAKISTAN
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Abstract
Introduction: Polycystic ovary syndrome (PCOS) is characterized by ovulatory dysfunction, hyperandrogenemia, and polycystic ovarian morphology (PCOM), with a prevalence of 8%–13% in women and 3.4%–19.6% in adolescent girls.
Objective: The main objective of the study is to find the impact of variations in diagnostic criteria for adolescent polycystic ovary syndrome (PCOS), excluding polycystic ovarian morphology, on diagnosis and treatment approaches in Pakistani population.
Methodology: This cross-sectional study was conducted at Department of Gynae and Obst, DHQ KDA Kohat during Jan 2023 to Feb 2024. Data were collected from 320 adolescent females aged between 12 and 19 years, who visited the clinic for evaluation of menstrual irregularities, signs of hyperandrogenism (such as acne, hirsutism, and alopecia), or concerns related to infertility.
Results: Data were collected from 320 patients with average age of the participants was 23.45 ± 10.98 years. A majority of the participants (56.3%) were classified as overweight or obese (BMI ≥ 25 kg/m²), while 43.7% had a normal BMI. A significant portion of the cohort (37.5%) reported a family history of PCOS. Menstrual irregularities, specifically oligomenorrhea, were observed in 65.6% of the participants, with 34.4% experiencing amenorrhea for three months or more. The results indicate that 47% of the participants exhibited hirsutism, with a Ferriman-Gallwey score of ≥ 6, while 43.7% had acne, and 31.3% experienced alopecia. Elevated total testosterone levels (≥ 60 ng/dL) were observed in 40.6% of the participants, and 25% had elevated DHEAS levels (≥ 250 µg/dL).
Conclusion: It is concluded that variations in diagnostic criteria for adolescent PCOS, particularly the exclusion of Polycystic Ovarian Morphology (PCOM), do not significantly affect the identification of key clinical and metabolic features such as insulin resistance, hyperandrogenism, and menstrual irregularities.
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Sadaf Ijaz
Consultant Gynaecologist, Gynae and Obst Department DHQ KDA Kohat
Momenah Maqsood
Female Medical Officer, Gynaecologist Health Department District Health Office, Mirpur AJK
Shahida Malik
Assistant Professor Obstetrics And Gynaecology Sialkot Medical College Kiran International Hospital, Idrees Hospital Sialkot
Ghulam Sughra
Consultant Gynaecologist Department of Obstetrics and Gynaecology Asian Institute of Medical and Health Sciences(AIMS) Hyderabad Sindh
Nusrum Iqbal
Chairman Department of Internal Medicine MD Health Center Lahore
Bazgha Dilpazir
Obs and Gynae Department Divisional headquarter teaching hospital Mirpur Azad Kashmir