Researchers at the Cedars-Sinai Medical Center and the University of Alabama have found that a complex hormonal disorder affecting the reproductive and metabolic function of premenopausal women may be much more common in the U.S. than previously believed from earlier studies. Their research appears in the Journal of Clinical Endocrinology and Metabolism. "This is the single largest study concerning the prevalence of the Polycystic Ovary Syndrome in this country, and the data support the concept that PCOS is the most common endocrine abnormality of reproductive-aged women," said Ricardo Azziz, Chair of Cedars-Sinai's Department of Obstetrics and Gynecology. In an earlier study of 277 18-to-45 year-old women, Dr. Azziz and his colleagues found that PCOS affected an estimated 4 percent of reproductive-age women, a lower percentage than has been found in studies in Greece, the United Kingdom and Spain. The largest patient sample in those studies was 230.
According to the new study, about 6.6 percent of premenopausal women in the United States have PCOS, an estimate that is comparable to those found in the European studies. The analysis was based on the results of medical histories, physical exams and lab results of 400 women undergoing pre-employment physicals - a factor that likely makes this a more representative sample than those previously studied.
Previous PCOS studies have recruited patients for a 'health evaluation' or a 'study of women's health issues.' It is possible that these offers could inadvertently skew the sample by attracting a higher-than-average number of respondents who have medical conditions. The researchers attempted to avoid this potential bias by having an "unselected" group of women, not those seeking treatment or a clinical trial.
Women with PCOS have many small cysts on the periphery of the ovaries. In most instances, they also have excessive levels of androgens, so-called "male" hormones, that normally exist at low levels in women. Symptoms include menstrual irregularities, excess weight, skin problems, and an excess of male-type hair growth. Many women with PCOS are found to have insulin resistance, a condition that allows high levels of insulin to circulate in the blood, increasing the risks of developing Type 2 diabetes, hypertension and heart disease.
Because the disorder often goes undiagnosed, many women struggle with symptoms and complications such as acne, infertility, obesity and hirsutism without addressing the underlying cause. Physicians at centers specializing in complicated reproductive and endocrine disorders can use blood tests, physical examinations and imaging techniques to diagnose PCOS and androgen excess, and in most cases, the administration of medications and hormones can restore normal balances and minimize symptoms.
