The goals of this cross-sectional survey of women aged 18 to 25 years, recruited from universities and general practices, were to determine the prevalence of polycystic ovaries in the normal population of young postmenarcheal women and to learn how they are related, if at all, to clinical and biochemical features of polycystic ovary syndrome (PCOS). The population was almost totally white, with two thirds of the women in social classes I and II. The 230 participants were evaluated by transabdominal pelvic ultrasonography, performed in the early follicular phase of the cycle in women not using oral contraception. Those taking the pill attended during the pill-free interval.
Polycystic ovaries were found in 33 percent of the women examined, independently of hormonal contraceptive use. Among nonusers, menstrual irregularity was 20 percent more frequent in women with polycystic ovaries; the difference approached significance. Polycystic ovaries could not be related to acne, hirsutism, excessive body weight, or body mass index. Women not using hormonal contraception had higher testosterone levels when polycystic ovaries were present, but no correlation with concentrations of gonadotropins, estradiol, androstenedione, dehydroepiandrosterone sulfate, sex hormone–binding globulin, or insulin was found. Other features of PCOS were identified in 26 percent of the study population but frequently were found in those lacking polycystic ovaries. PCOS was associated with a greater average body mass index.
An ultrasound finding of polycystic ovaries is quite common in young women, but polycystic ovaries are not necessarily associated with other clinical or hormonal features of PCOS. Large-scale prospective follow-up studies are needed to determine whether polycystic ovaries are sometimes a “normal variant.”
Clin Endocrinol 1999;51:779–786