Endocrine Abstracts

Introduction: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women and its main symptoms are related to menstrual disorders and hyperandrogenism. The aim of our study was to evaluate the clinical and paraclinical profile of PCOS.

Methods: We conducted a retrospective study that included 50 women, followed at endocrinology department’s consultations of Rabta Hospital in Tunis. Each patient underwent a clinical examination, hormone assays and ovarian ultrasound. The diagnosis of PCOS was made according to the Rotterdam 2003 criteria.

Results: The mean age of our patients was 26.9±7.9 years [15 -45]. The family history of PCOS was found in 24% and type 2 diabetes mellitus’s personal medical history in 21.7%. Eight percent of patients were smokers. The mean age of menarche was 12.1 ± 1.3 years. Sixty-two percent of patients had spaniomenorrhoea and 6% had secondary amenorrhoea. These disorders were post-pubertal in half cases. The average weight was 87.5 ± 21.9 kg [38-150] for an average body mass index of 33.3 ± 7.6 kg/m² [16-57]. Therefore 65% of patients were obese and 37% presented acanthosis nigricans on clinical examination. Clinical hyperandrogenism signs such as acne and hyperseborrhea were found in 22.7% while major virilizationsigns were noted in 4%. Hirsutism was classified moderate to severe in 60.8%. Biological hyperandrogenism was found in 62% of cases including mean testosterone level of 0.78 ± 0.4 ng/ml. The average LH/FSH ratio was 1.7 ± 0.9, and was higher than 2 in 29%. Ovarian ultrasound showed a polycystic aspect in 72% of cases with increased ovaries size in 56%, the rest were strictly normal. Hygienic diet was instituted in 96% associated to metformin in 18% of cases and an Oestrogen -Progestin combination therapy in 60%. An additional laser hair removal treatment was done in 28%. Clinical and biological improvement was noted in half cases.

Conclusion: The etiological investigation of hyperandrogenism with menstrual disorders should remain exhaustive to eliminate potentially serious diagnoses. PCOS remains a benign disease. However, it must be managed effectively, given its impact on the patient’s quality of life.