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Do hyperandrogenic women with normal menses have polycystic ovary syndrome?
1Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA.
Objective:
To determine the prevalence of polycystic ovary syndrome (PCOS) among hyperandrogenic women who report normal menses.
Design:
Prospective observational study.
Setting:
Academic practice in reproductive endocrinology.
Patient(S):
Fifty-eight consecutively seen new patients with hyperandrogenism who reported normal menses.
Intervention(S):
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.
Main Outcome Measure(S):
Determination of ovulatory status, polycystic appearance of ovaries, and increased response of 17-OHP to leuprolide acetate.
Result(S):
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.
Conclusion(S):
The data suggest that most (74%) hyperandrogenic women who report normal menses have evidence for the diagnosis of PCOS.