Endocrine Abstracts

Objective: To investigate comorbidity rate, symptoms, overall morbidity, medication useand use of health care services among women with polycystic ovary syndrome (PCOS).

Design: Community-based prospective cohort study.

Patients: Womenreporting oligo/amenorrhea and hirsutism at age 31 and/or PCOS diagnosis by age 46 (n = 280) and controls without PCOS related symptoms or diagnosis (n = 1573) in the Northern Finland Birth Cohort 1966.

Main outcome measures: Self-reported diseases and symptoms diagnosed by a doctor, overall morbidity score calculated from the self-reported diagnoses, medication and supplement use and use of health care services at ages 31 and 46.

Results: The overall morbidity was increased in women with PCOS as they reported having higher occurrence of diagnosed diseases both at age 31 and 46 years. Moreover, the overall medication use was higher among affected, especially before adjustment with BMI. Women with PCOS had a higher risk for diagnosed disease at both ages [31: RR (95% CI): 1.19 (1.02 – 1.39) and 46: RR: 1.29 (1.11 – 1.50)]. Diseases more prevalent in PCOS even after adjustments both at age 31 and 46 were gastric/duodenal ulcer [OR (95% CI): 2.79 (1.02 – 7.64) and 2.12 (1.01 – 4.45), respectively], migraine [1.50 (1.05 – 2.14) and 1.58 (1.17 -2.13)] and fractures [1.63 (1.13 – 2.36) and 1.73 (1.24 – 2.41)].By age 31, women with PCOS had a higher prevalence of repeated respiratory infections, emphysema/chronic bronchitis, gynecological infections, cancer and other sickness or injury compared to control women. Furthermore, by age 46, women with PCOS had a higher prevalence of hypertension, type 2 diabetes mellitus, hypothyroidism, hyperthyroidism, salpingo-oophoritis, depression, tendinitis as well as knee, back and shoulderosteoarthritis, fibromyalgia, pre-eclampsia and endometriosis. As for infections, the women reported having more often recurrent infections, pneumonias, recurrent otitis, common colds and higher susceptibility to infections than other women. In addition, women with PCOS reported more often symptoms related to autoimmune diseases. Interestingly, use of health care services did not differbetweenthe groups either at age 31 nor 46. All results were adjusted for BMI, alcohol consumption, smoking, physical activity, education and marital status.

Conclusion: Women with PCOS are burdened with extensive comorbidity up till late fertile age independent of BMI, although higher BMI aggravates the risk for medication usage. Identification of the women with the syndrome as well as early preventive actions should be considered to alleviate health risks related to the syndrome.