Do hyperandrogenic women with normal menses have polycystic ovary syndrome?
OBJECTIVE
To determine the prevalence of polycystic ovary syndrome (PCOS) among hyperandrogenic women who report normal menses.


METHODS
Prospective observational study.


METHODS
Academic practice in reproductive endocrinology.


METHODS
Fifty-eight consecutively seen new patients with hyperandrogenism who reported normal menses.


METHODS
Ovulatory status was assessed with timed serum progesterone measurements. The following tests also were carried out: vaginal ultrasound examination; measurement of the ovarian response of 17-hydroxyprogesterone (17-OHP) after the administration of leuprolide acetate, 1 mg SC; and determination of fasting serum LH, FSH, E2, 17-OHP, insulin, and androgen levels.


METHODS
Determination of ovulatory status, polycystic appearance of ovaries, and increased response of 17-OHP to leuprolide acetate.


RESULTS
Twelve (20.7%) of the hyperandrogenic women were anovulatory and met the usual criteria for the diagnosis of PCOS. The ovulatory patients had lower serum total and unbound testosterone levels. Thirty-one (53.4%) of the ovulatory women had polycystic ovaries on ultrasound examination and/or an increased 17-OHP response to leuprolide acetate, suggesting the diagnosis of PCOS despite the presence of ovulation. Considering both the anovulatory and ovulatory patients, 74% of the hyperandrogenic women studied could have PCOS.


CONCLUSIONS
The data suggest that most (74%) hyperandrogenic women who report normal menses have evidence for the diagnosis of PCOS.
Carmina
E
E
Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA.
Lobo
R A
RA
D019326:17-alpha-Hydroxyprogesterone / Q000378:metabolism; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000209:etiology*; D008597:Menstrual Cycle / Q000502:physiology*; D010053:Ovary / Q000473:pathology; D010060:Ovulation / Q000502:physiology; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D015995:Prevalence; D011446:Prospective Studies; D011966:Receptors, LHRH / Q000819:agonists