CLINICAL PROFILE AND OUTCOMES OF PATIENTS WITH POLYCYSTIC OVARIAN SYNDROME
Main Article Content
Keywords
Hyperandrogenism, Insulin Resistance, Metabolic Syndrome, Polycystic Ovarian Syndrome, Rotterdam Criteria
Abstract
Polycystic ovarian syndrome (PCOS) is the most prevalent endocrine disorder affecting reproductive-age women globally, with prevalence ranging 5-26%. Despite its significance, comprehensive clinical profiling and outcome assessment remain limited in South Asian populations. This study aimed to evaluate clinical characteristics and treatment outcomes in women with PCOS at a tertiary care center.
Methods: A prospective observational study was conducted at Gynecology, Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh from June 2015 to July 2016. One hundred eighty women aged 18-40 years diagnosed with PCOS according to Rotterdam criteria were enrolled using consecutive sampling. Comprehensive clinical, anthropometric, biochemical, and hormonal assessments were performed. Treatment outcomes were evaluated at 6-month follow-up. Statistical analysis was performed using SPSS version 20.0.
Results: Mean age was 24.6±4.8 years with 70% participants having BMI≥25 kg/m². Menstrual irregularities affected 90% participants, hirsutism 75%, and polycystic ovarian morphology 85%. Insulin resistance (HOMA-IR>2.5) was present in 60% participants, with 80% showing elevated testosterone levels. Family history of diabetes and PCOS was observed in 40% and 30% respectively. Treatment interventions demonstrated significant improvements: lifestyle modifications reduced BMI (26.8±5.2 to 25.4±4.8 kg/m², p<0.001), metformin improved insulin sensitivity, oral contraceptives reduced hyperandrogenic symptoms, and clomiphene achieved 72.2% ovulation rate with 33.3% pregnancy rate.
Conclusion: PCOS presents as a complex metabolic-reproductive syndrome with high prevalence of obesity, insulin resistance, and metabolic dysfunction in South Asian women. Comprehensive, individualized treatment approaches significantly improve clinical outcomes and quality of life, emphasizing the importance of multidisciplinary management strategies.
References
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9. Dokras, A., Clifton, S., Futterweit, W., & Wild, R. (2011). Increased risk for abnormal depression scores in women with polycystic ovary syndrome: a systematic review and meta-analysis. Obstetrics & Gynecology, 117(1), 145-152. doi:10.1097/AOG.0b013e318202b0a4
10. Dunaif, A. (2012). Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocrine Reviews, 18(6), 774-800. doi:10.1210/edrv.18.6.0318
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12. Joshi, B., Mukherjee, S., Patil, A., Purandare, A., Chauhan, S., & Vaidya, R. (2014). A cross-sectional study of polycystic ovarian syndrome among adolescent and young girls in Mumbai, India. Indian Journal of Endocrinology and Metabolism, 18(3), 317-324. doi:10.4103/2230-8210.131162
13. Lim, S. S., Davies, M. J., Norman, R. J., & Moran, L. J. (2012). Overweight, obesity and central obesity in women with polycystic ovary syndrome: a systematic review and meta-analysis. Human Reproduction Update, 18(6), 618-637. doi:10.1093/humupd/dms030
14. Moran, L. J., Hutchison, S. K., Norman, R. J., & Teede, H. J. (2011). Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database of Systematic Reviews, (2). doi:10.1002/14651858.CD007506.pub2
15. Moran, L. J., Misso, M. L., Wild, R. A., & Norman, R. J. (2010). Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: a systematic review and meta-analysis. Human Reproduction Update, 16(4), 347-363. doi:10.1093/humupd/dmq001
16. Moran, L. J., Pasquali, R., Teede, H. J., Hoeger, K. M., & Norman, R. J. (2009). Treatment of obesity in polycystic ovary syndrome: a position statement of the Androgen Excess and Polycystic Ovary Syndrome Society. Fertility and Sterility, 92(6), 1966-1982. doi:10.1016/j.fertnstert.2008.09.018
17. Nestler, J. E. (2008). Metformin for the treatment of the polycystic ovary syndrome. New England Journal of Medicine, 358(1), 47-54. doi:10.1056/NEJMct0707092
18. Norman, R. J., Dewailly, D., Legro, R. S., & Hickey, T. E. (2007). Polycystic ovary syndrome. The Lancet, 370(9588), 685-697. doi:10.1016/S0140-6736(07)61345-2
19. Rosenfield, R. L. (2005). Hirsutism. New England Journal of Medicine, 353(24), 2578-2588. doi:10.1056/NEJMcp033496
20. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. (2004). Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertility and Sterility, 81(1), 19-25. doi:10.1016/j.fertnstert.2003.10.004
21. Wild, R. A., Carmina, E., Diamanti-Kandarakis, E., Dokras, A., Escobar-Morreale, H. F., Futterweit, W., ... & Norman, R. J. (2010). Assessment of cardiovascular risk and prevention of cardiovascular disease in women with the polycystic ovary syndrome: a consensus statement by the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society. Journal of Clinical Endocrinology & Metabolism, 95(5), 2038-2049. doi:10.1210/jc.2009-2724
22. Bhattacharya, S. M., Jha, A., & Majumdar, A. (2007). Anovulatory androgen excess among Indian women. International Journal of Gynecology & Obstetrics, 96(2), 117-121. doi:10.1016/j.ijgo.2006.09.016
23. Brown, J., Farquhar, C., Beck, J., Boothroyd, C., & Hughes, E. (2009). Clomiphene and anti-oestrogens for ovulation induction in PCOS. Cochrane Database of Systematic Reviews, (4). doi:10.1002/14651858.CD002249.pub4
24. Coffey, S., Bano, G., & Mason, H. D. (2003). Health-related quality of life in women with polycystic ovary syndrome: a comparison with the general population using the Polycystic Ovary Syndrome Questionnaire (PCOSQ) and the Short Form-36 (SF-36). Gynecological Endocrinology, 17(3), 207-216. doi:10.1080/gye.17.3.207.216
25. Ehrmann, D. A., Liljenquist, D. R., Kasza, K., Azziz, R., Legro, R. S., & Ghazzi, M. N. (2005). Prevalence and predictors of the metabolic syndrome in women with polycystic ovary syndrome. Journal of Clinical Endocrinology & Metabolism, 91(1), 48-53. doi:10.1210/jc.2005-1329
26. Kahsar-Miller, M. D., Nixon, C., Boots, L. R., Go, R. C., & Azziz, R. (2001). Prevalence of polycystic ovary syndrome (PCOS) in first-degree relatives of patients with PCOS. Fertility and Sterility, 75(1), 53-58. doi:10.1016/S0015-0282(00)01662-9
27. Kumarapeli, V., Seneviratne, R. D. A., Wijeyaratne, C. N., Yapa, R. M., & Dodampahala, S. H. (2008). A simple screening approach for assessing community prevalence and phenotype of polycystic ovary syndrome in a semi-urban population in Sri Lanka. American Journal of Epidemiology, 168(3), 321-328. doi:10.1093/aje/kwn137
28. Moran, L. J., Pasquali, R., Teede, H. J., Hoeger, K. M., & Norman, R. J. (2009). Treatment of obesity in polycystic ovary syndrome: a position statement of the Androgen Excess and Polycystic Ovary Syndrome Society. Fertility and Sterility, 92(6), 1966-1982. doi:10.1016/j.fertnstert.2008.09.018
29. Palomba, S., Falbo, A., Zullo, F., & Orio Jr, F. (2009). Evidence-based and potential benefits of metformin in the polycystic ovary syndrome: a comprehensive review. Endocrine Reviews, 30(1), 1-50. doi:10.1210/er.2008-0030
30. Pigny, P., Merlen, E., Robert, Y., Cortet-Rudelli, C., Decanter, C., Jonard, S., & Dewailly, D. (2003). Elevated serum level of anti-müllerian hormone in patients with polycystic ovary syndrome: relationship to the ovarian follicle excess and to the follicular arrest. Journal of Clinical Endocrinology & Metabolism, 88(12), 5957-5962. doi:10.1210/jc.2003-030727
31. Ranasinha, S., Joham, A. E., Norman, R. J., Mellett, N. A., Meikle, P. J., Delacroix, S., ... & Teede, H. J. (2013). The association between polycystic ovary syndrome and endogenous androgen levels is modified by body mass index. Clinical Endocrinology, 78(3), 397-404. doi:10.1111/j.1365-2265.2012.04506.x
32. Sharma, A., Mittal, S., & Aggarwal, P. (2008). Management of infertility in polycystic ovary syndrome. Best Practice & Research Clinical Obstetrics & Gynaecology, 22(4), 687-710. doi:10.1016/j.bpobgyn.2008.01.013
33. Singh, N., Madaan, M., Bansal, Y., Kakkar, R., & Khullar, M. (2008). Study of clinical, biochemical and histopathological changes in polycystic ovary syndrome. Indian Journal of Clinical Biochemistry, 23(4), 326-329. doi:10.1007/s12291-008-0072-6
34. Vaidya, R. A., Joshi, B. V., Bantwal, G., Jawalekar, S., & Patel, K. A. (2006). Polycystic ovarian disease in Indian subcontinent. International Journal of Diabetes in Developing Countries, 26(4), 165-169. doi:10.4103/0973-3930.34758
35. Weerakiet, S., Srisombut, C., Bunnag, P., Sangtong, S., Chuangsoongnoen, N., & Rojanasakul, A. (2007). Prevalence of type 2 diabetes mellitus and impaired glucose tolerance in Asian women with polycystic ovary syndrome. International Journal of Gynecology & Obstetrics, 97(2), 129-134. doi:10.1016/j.ijgo.2007.01.004
2. Azziz, R., Carmina, E., Dewailly, D., Diamanti-Kandarakis, E., Escobar-Morreale, H. F., Futterweit, W., ... & Witchel, S. F. (2006). Criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. Journal of Clinical Endocrinology & Metabolism, 91(11), 4237-4245. doi:10.1210/jc.2006-0178
3. Azziz, R., Carmina, E., Dewailly, D., Diamanti-Kandarakis, E., Escobar-Morreale, H. F., Futterweit, W., ... & Witchel, S. F. (2009). The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report. Fertility and Sterility, 91(2), 456-488. doi:10.1016/j.fertnstert.2008.06.035
4. Azziz, R., Marin, C., Hoq, L., Badamgarav, E., & Song, P. (2005). Health care-related economic burden of the polycystic ovary syndrome during the reproductive life span. Journal of Clinical Endocrinology & Metabolism, 90(8), 4650-4658. doi:10.1210/jc.2005-0628
5. Balen, A. H., Laven, J. S., Tan, S. L., & Dewailly, D. (2003). Ultrasound assessment of the polycystic ovary: international consensus definitions. Human Reproduction Update, 9(6), 505-514. doi:10.1093/humupd/dmg044
6. Boomsma, C. M., Eijkemans, M. J., Hughes, E. G., Visser, G. H., Fauser, B. C., & Macklon, N. S. (2006). A meta-analysis of pregnancy outcomes in women with polycystic ovary syndrome. Human Reproduction Update, 12(6), 673-683. doi:10.1093/humupd/dml036
7. Chen, Z. J., Zhao, H., He, L., Shi, Y., Qin, Y., Shi, Y., ... & Zhao, J. (2011). Genome-wide association study identifies susceptibility loci for polycystic ovary syndrome on chromosome 2p16.3, 2p21 and 9q33.3. Nature Genetics, 43(1), 55-59. doi:10.1038/ng.732
8. Costello, M., Shrestha, B., Eden, J., Sjoblom, P., & Johnson, N. (2007). Insulin-sensitising drugs versus the combined oral contraceptive pill for hirsutism, acne and risk of diabetes, cardiovascular disease, and endometrial cancer in polycystic ovary syndrome. Cochrane Database of Systematic Reviews, (1). doi:10.1002/14651858.CD005552.pub2
9. Dokras, A., Clifton, S., Futterweit, W., & Wild, R. (2011). Increased risk for abnormal depression scores in women with polycystic ovary syndrome: a systematic review and meta-analysis. Obstetrics & Gynecology, 117(1), 145-152. doi:10.1097/AOG.0b013e318202b0a4
10. Dunaif, A. (2012). Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocrine Reviews, 18(6), 774-800. doi:10.1210/edrv.18.6.0318
11. Franks, S. (2006). Controversy in clinical endocrinology: diagnosis of polycystic ovarian syndrome: in defense of the Rotterdam criteria. Journal of Clinical Endocrinology & Metabolism, 91(3), 786-789. doi:10.1210/jc.2005-2501
12. Joshi, B., Mukherjee, S., Patil, A., Purandare, A., Chauhan, S., & Vaidya, R. (2014). A cross-sectional study of polycystic ovarian syndrome among adolescent and young girls in Mumbai, India. Indian Journal of Endocrinology and Metabolism, 18(3), 317-324. doi:10.4103/2230-8210.131162
13. Lim, S. S., Davies, M. J., Norman, R. J., & Moran, L. J. (2012). Overweight, obesity and central obesity in women with polycystic ovary syndrome: a systematic review and meta-analysis. Human Reproduction Update, 18(6), 618-637. doi:10.1093/humupd/dms030
14. Moran, L. J., Hutchison, S. K., Norman, R. J., & Teede, H. J. (2011). Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database of Systematic Reviews, (2). doi:10.1002/14651858.CD007506.pub2
15. Moran, L. J., Misso, M. L., Wild, R. A., & Norman, R. J. (2010). Impaired glucose tolerance, type 2 diabetes and metabolic syndrome in polycystic ovary syndrome: a systematic review and meta-analysis. Human Reproduction Update, 16(4), 347-363. doi:10.1093/humupd/dmq001
16. Moran, L. J., Pasquali, R., Teede, H. J., Hoeger, K. M., & Norman, R. J. (2009). Treatment of obesity in polycystic ovary syndrome: a position statement of the Androgen Excess and Polycystic Ovary Syndrome Society. Fertility and Sterility, 92(6), 1966-1982. doi:10.1016/j.fertnstert.2008.09.018
17. Nestler, J. E. (2008). Metformin for the treatment of the polycystic ovary syndrome. New England Journal of Medicine, 358(1), 47-54. doi:10.1056/NEJMct0707092
18. Norman, R. J., Dewailly, D., Legro, R. S., & Hickey, T. E. (2007). Polycystic ovary syndrome. The Lancet, 370(9588), 685-697. doi:10.1016/S0140-6736(07)61345-2
19. Rosenfield, R. L. (2005). Hirsutism. New England Journal of Medicine, 353(24), 2578-2588. doi:10.1056/NEJMcp033496
20. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. (2004). Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertility and Sterility, 81(1), 19-25. doi:10.1016/j.fertnstert.2003.10.004
21. Wild, R. A., Carmina, E., Diamanti-Kandarakis, E., Dokras, A., Escobar-Morreale, H. F., Futterweit, W., ... & Norman, R. J. (2010). Assessment of cardiovascular risk and prevention of cardiovascular disease in women with the polycystic ovary syndrome: a consensus statement by the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society. Journal of Clinical Endocrinology & Metabolism, 95(5), 2038-2049. doi:10.1210/jc.2009-2724
22. Bhattacharya, S. M., Jha, A., & Majumdar, A. (2007). Anovulatory androgen excess among Indian women. International Journal of Gynecology & Obstetrics, 96(2), 117-121. doi:10.1016/j.ijgo.2006.09.016
23. Brown, J., Farquhar, C., Beck, J., Boothroyd, C., & Hughes, E. (2009). Clomiphene and anti-oestrogens for ovulation induction in PCOS. Cochrane Database of Systematic Reviews, (4). doi:10.1002/14651858.CD002249.pub4
24. Coffey, S., Bano, G., & Mason, H. D. (2003). Health-related quality of life in women with polycystic ovary syndrome: a comparison with the general population using the Polycystic Ovary Syndrome Questionnaire (PCOSQ) and the Short Form-36 (SF-36). Gynecological Endocrinology, 17(3), 207-216. doi:10.1080/gye.17.3.207.216
25. Ehrmann, D. A., Liljenquist, D. R., Kasza, K., Azziz, R., Legro, R. S., & Ghazzi, M. N. (2005). Prevalence and predictors of the metabolic syndrome in women with polycystic ovary syndrome. Journal of Clinical Endocrinology & Metabolism, 91(1), 48-53. doi:10.1210/jc.2005-1329
26. Kahsar-Miller, M. D., Nixon, C., Boots, L. R., Go, R. C., & Azziz, R. (2001). Prevalence of polycystic ovary syndrome (PCOS) in first-degree relatives of patients with PCOS. Fertility and Sterility, 75(1), 53-58. doi:10.1016/S0015-0282(00)01662-9
27. Kumarapeli, V., Seneviratne, R. D. A., Wijeyaratne, C. N., Yapa, R. M., & Dodampahala, S. H. (2008). A simple screening approach for assessing community prevalence and phenotype of polycystic ovary syndrome in a semi-urban population in Sri Lanka. American Journal of Epidemiology, 168(3), 321-328. doi:10.1093/aje/kwn137
28. Moran, L. J., Pasquali, R., Teede, H. J., Hoeger, K. M., & Norman, R. J. (2009). Treatment of obesity in polycystic ovary syndrome: a position statement of the Androgen Excess and Polycystic Ovary Syndrome Society. Fertility and Sterility, 92(6), 1966-1982. doi:10.1016/j.fertnstert.2008.09.018
29. Palomba, S., Falbo, A., Zullo, F., & Orio Jr, F. (2009). Evidence-based and potential benefits of metformin in the polycystic ovary syndrome: a comprehensive review. Endocrine Reviews, 30(1), 1-50. doi:10.1210/er.2008-0030
30. Pigny, P., Merlen, E., Robert, Y., Cortet-Rudelli, C., Decanter, C., Jonard, S., & Dewailly, D. (2003). Elevated serum level of anti-müllerian hormone in patients with polycystic ovary syndrome: relationship to the ovarian follicle excess and to the follicular arrest. Journal of Clinical Endocrinology & Metabolism, 88(12), 5957-5962. doi:10.1210/jc.2003-030727
31. Ranasinha, S., Joham, A. E., Norman, R. J., Mellett, N. A., Meikle, P. J., Delacroix, S., ... & Teede, H. J. (2013). The association between polycystic ovary syndrome and endogenous androgen levels is modified by body mass index. Clinical Endocrinology, 78(3), 397-404. doi:10.1111/j.1365-2265.2012.04506.x
32. Sharma, A., Mittal, S., & Aggarwal, P. (2008). Management of infertility in polycystic ovary syndrome. Best Practice & Research Clinical Obstetrics & Gynaecology, 22(4), 687-710. doi:10.1016/j.bpobgyn.2008.01.013
33. Singh, N., Madaan, M., Bansal, Y., Kakkar, R., & Khullar, M. (2008). Study of clinical, biochemical and histopathological changes in polycystic ovary syndrome. Indian Journal of Clinical Biochemistry, 23(4), 326-329. doi:10.1007/s12291-008-0072-6
34. Vaidya, R. A., Joshi, B. V., Bantwal, G., Jawalekar, S., & Patel, K. A. (2006). Polycystic ovarian disease in Indian subcontinent. International Journal of Diabetes in Developing Countries, 26(4), 165-169. doi:10.4103/0973-3930.34758
35. Weerakiet, S., Srisombut, C., Bunnag, P., Sangtong, S., Chuangsoongnoen, N., & Rojanasakul, A. (2007). Prevalence of type 2 diabetes mellitus and impaired glucose tolerance in Asian women with polycystic ovary syndrome. International Journal of Gynecology & Obstetrics, 97(2), 129-134. doi:10.1016/j.ijgo.2007.01.004
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Aug 04, 2025
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Dr. Mili Poonia. (2025). CLINICAL PROFILE AND OUTCOMES OF PATIENTS WITH POLYCYSTIC OVARIAN SYNDROME. Journal of Population Therapeutics and Clinical Pharmacology, 23(3), 201-216. https://doi.org/10.53555/6vtsz040
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Author Biography
Dr. Mili Poonia
Assistant Professor, Department of Obstetrics and Gynecology, Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh
How to Cite
Dr. Mili Poonia. (2025). CLINICAL PROFILE AND OUTCOMES OF PATIENTS WITH POLYCYSTIC OVARIAN SYNDROME. Journal of Population Therapeutics and Clinical Pharmacology, 23(3), 201-216. https://doi.org/10.53555/6vtsz040