OBJECTIVE: To determine whether hormonal, metabolic, and anthropomorphic parameters change over 20 years in women with polycystic ovary syndrome (PCOS).
METHODS: One hundred ninety-three women with PCOS, aged 20–25 years, were diagnosed according to Rotterdam criteria, divided into four phenotypes (A–D), and followed at 5-year intervals for 20 years. Androgens, gonadotropins, insulin, glucose, body mass index, waist circumference, and ovarian volume were measured.
RESULTS: At diagnosis, 57% had classic features (phenotype A), 9% had classic features without ovarian findings (phenotype B), 26% had the ovulatory phenotype (C), and 7% were nonhyperandrogenic (D). After 10 years, androgens decreased (P<.05); at 15 years, waist circumference increased (P<.05); at 20 years, ovarian volume decreased (P<.01). Serum luteinizing hormone and follicle-stimulating hormone decreased nonsignificantly and fasting insulin and quantitative insulin-sensitivity check index were unchanged. Eighty-five women (44%) were ovulatory at 20 years, and 18 women (8%) could no longer be diagnosed as having PCOS.
CONCLUSION: After 20 years of follow-up in women with PCOS, androgens and ovarian volume decreased and there were more ovulatory cycles suggesting a milder disorder, whereas metabolic abnormalities persisted and waist circumference increased.
LEVEL OF EVIDENCE: II
A 20-year follow-up of 193 women with polycystic ovary syndrome shows that androgens and ovarian volume decrease and ovulatory cycles increase, but metabolic abnormalities persist.
From the Department of Biological and Medical Sciences, University of Palermo, Palermo, Italy; and the Department of Obstetrics and Gynecology, Columbia University, New York, New York.
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Corresponding author: Roger A. Lobo, MD, Columbia University Medical Center, 622 West 168 Street, Room 16-65, New York, NY 10032; e-mail: email@example.com.
Financial Disclosure The authors did not report any potential conflicts of interest.