High prevalence of polycystic ovary syndrome in women with mild hirsutism and no other significant clinical symptoms

• Published in: Fertility and sterility Vol. 94; no. 1; pp. 194 - 197
• Main Authors: Di Fede, Gaetana, M.D, Mansueto, Pasquale, M.D, Pepe, Ilenia, M.D, Rini, Giovam Battista, M.D, Carmina, Enrico, M.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-06-2010; Elsevier
• Subjects: 17-alpha-Hydroxyprogesterone - blood; Adult; Biological and medical sciences; Female; Female genital diseases; Gynecology. Andrology. Obstetrics; hirsultism; Hirsutism - blood; Hirsutism - diagnosis; Hirsutism - epidemiology; Humans; Hyperandrogenism; Internal Medicine; Medical sciences; Non tumoral diseases; nonclassic adrenal hyperplasia; Obstetrics and Gynecology; PCOS; Polycystic Ovary Syndrome - blood; Polycystic Ovary Syndrome - diagnosis; Polycystic Ovary Syndrome - epidemiology; Prevalence; Puberal and climacteric disorders (male and female); Retrospective Studies; Young Adult; hirsultism; Hyperandrogenism; PCOS; nonclassic adrenal hyperplasia; Endocrinopathy; Skin disease; Prevalence; Adrenal glands; Hyperplasia; Polycystic ovary; Epidemiology; Cyst; Female; Benign neoplasm; Woman; Human; Hair; Gynecology; Hirsutism; Female sterility; Obstetrics; Female genital diseases; Ovarian diseases; Symptomatology; Masculinization
• ISSN: 0015-0282; 1556-5653
• DOI: 10.1016/j.fertnstert.2009.02.056

Objective To verify the conclusions of the Endocrine Society Guidelines that patients with mild hirsutism and no other important clinical signs (menstrual irregularities, infertility, central obesity, acanthosis nigricans, rapid progression of the hirsutism, clitoromegaly) should not be further studied. Design Retrospective study in patients referred because of mild hirsutism and no other clinical signs. Setting Department of Clinical Medicine of the University of Palermo. Patient(s) One hundred fifty-two patients with mild hirsutism. Intervention(s) Measurement of serum testosterone, dehydroepiandrosterone sulfate, 17-OH-Progesterone, assessment of ovulation by measurement of progesterone in 21 to 24 days and ovarian ultrasound. Result(s) In 72 (47%) patients a diagnosis of polycyctic ovarian syndrome (PCOS) was performed. Polycyctic ovarian syndrome patients included 56 patients with the mild ovulatory form (OV-PCOS) but also 16 patients with the anovulatory form (classic PCOS). Three (2%) patients had nonclassic adrenal hyperplasia. Conclusion(s) Because of the high prevalence of PCOS and the possibility of finding nonclassic 21-hydroxylase deficiency, patients with mild hirsutism need a diagnostic evaluation that should include 17-hydroxyprogesterone measurement plus assessment of ovulation and ovarian ultrasound.