Changing Profile of the PCOS Women: A 15 Year Retrospective Cohort Study

Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting reproductive-aged women, with a global prevalence of 5%-10%, and up to 25% in certain populations. Developing countries like India have witnessed a surge in obesity and related metabolic comorbidities due to rapid urbanisation and lifestyle transitions. This study examines temporal changes in the clinical and metabolic profile of women with PCOS from Odisha, India, over the past 15 years.

This study aims to analyse how PCOS women have changed in their clinical, phenotypic, biochemical and metabolic parameters over the last two decades.

Private hospital and retrospective analysis.

This retrospective chart review included 1530 women diagnosed with PCOS (Rotterdam criteria) at a tertiary care centre in Odisha. Patients were grouped into three periods: Period 1 (2009-2013), Period 2 (2014-2018) and Period 3 (2019-2024), with approximately equal numbers. Anthropometric, biochemical and ultrasonographic features were compared across time periods.

The data were analysed using Chi-square and Kruskal-Wallis tests and the R v4.1.1 (R Core Team, 2021) software.

Mean body mass index increased from 26.40 ± 4.61 kg/m² (Period 1) to 28.42 ± 5.31 kg/m² (Period 3), P < 0.001. Waist circumference rose from 86.83 ± 11.18 cm to 90.78 ± 12.12 cm, P < 0.001. Abnormal glucose tolerance (glucose challenge test 75 g 2 h) (mg/dl) 129.95 ± 66.54 to 136.99 ± 44.37, P < 0.001 and fasting blood glucose (mgs/dl) 94.71 ± 17.36 to 94.91 ± 14.38, P < 0.001 also increased significantly. Family history of PCOS, diabetes mellitus, hypertension, obesity and dyslipidaemias significantly increased, indicating a rising prevalence of these conditions over time. Menstrual dysfunction remained consistently prevalent, with cycles of 60-90 days most frequent in Period 2 (59.1%). Metabolic syndrome prevalence increased from 36.5% to 45.6.

Over the last 15 years, the metabolic and phenotypic profile of Indian women with PCOS has worsened significantly. These findings highlight the need for early lifestyle interventions and public health strategies targeting metabolic risk factors in this population.