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Hormonal Profile of Women with Self-Reported Symptoms of Oligomenorrhea and/or Hirsutism: Northern Finland Birth Cohort 1966 Study

Departments of Clinical Chemistry (S.T., A.R.) and Obstetrics and Gynecology (S.T., H.M., A.-L.H.), University of Oulu and Oulu University Hospital, 90014 Oulu, Finland; Department of Public Health Science and General Practice (S.T., M.-R.J., A.P., U.S.), University of Oulu, 90014 Oulu, Finland; Oulu Regional Institute of Occupational Health (J.L.), 90220 Oulu, Finland; Department of Epidemiology and Public Health (M.-R.J., U.S.), Imperial College Faculty of Medicine, W2 1PG London, United Kingdom; Imperial College Genetics and Genomics Research Institute (M.I.M.), Imperial College Faculty of Medicine, W12 0NN London, United Kingdom; and Department of Reproductive Science and Medicine (S.F.), Institute of Reproductive and Developmental Biology, Imperial College of Science Technology and Medicine, W12 0NN London, United Kingdom

Address all correspondence and requests for reprints to: Saara Taponen, M.D., Department of Clinical Chemistry, University of Oulu, PL 5000, University of Oulu, 90014 Oulu, Finland. E-mail: saara.taponen{at}mail.suomi.net.

The hormonal profiles of nested female patients (n = 500) with self-reported symptoms typical of polycystic ovary syndrome (PCOS), oligomenorrhea, and/or hirsutism and their randomly selected controls (n = 1026) at the age of 31 yr were analyzed in a general population-based Northern Finland birth cohort 1966 to find out whether the symptomatic women also have the endocrine characteristics of PCOS and could be detected in a general population using simple questions. Higher medians of serum testosterone (T) (2.10 vs. 1.90 nmol/liter, P < 0.001), LH (5.40 vs. 4.85 U/liter, P = 0.005), insulin (53.8 vs. 51.66 pmol/liter, P = 0.040), and free androgen index (FAI) (4.01 vs. 3.03, P < 0.001) and lower glucose/insulin ratio (91.1 x 10⁸ vs. 94.9 x 10⁸, P = 0.048) and SHBG (52.4 vs. 60.7 nmol/liter, P < 0.001) were observed among the cases, but no difference was observed in cortisol and glucose levels between the cases and controls. Of all the women in the cohort, 10.2% reported only oligomenorrhea and had biochemical findings similar to the whole case group. Those who reported only hirsutism (10.4%) were in between the case and control groups according to biochemical findings. The subjects who reported both oligomenorrhea and hirsutism (3.4%) had the highest T, LH, FAI, insulin, and glucose and the lowest SHBG and glucose/insulin ratio, compared with the case group and the groups with either symptom only indicating a dose-response manner in typical endocrine profile of PCOS by adding up symptoms. The levels of T and FAI were higher and SHBG lower in groups with overweight or obesity both at 14 and 31 yr, compared with groups with normal weight at 14 yr and overweight or obesity at 31 yr. In the group with normal weight at 14 and 31 yr and the group with overweight or obesity at 14 yr but normal weight at 31 yr, the levels of T and FAI were lowest and SHBG highest. T and FAI were higher and SHBG lower among the cases than the controls in groups stratified by weight development from adolescence to adulthood. In conclusion, this longitudinal study of a large, stable population indicates that women with self-reported symptoms of hirsutism and/or oligomenorrhea show endocrine characteristics of PCOS and can be detected in a general population using simple questions. These symptoms are markers of the underlying metabolic alterations possibly associated with increased health risks in later life.

This work was supported by the Academy of Finland and European Commission, Quality of Life and Management of Living Sources Programme, contract QLG1-CT-2000-01643.

Abbreviations: BMI, Body mass index; FAI, free androgen index; PCOS, polycystic ovary syndrome; T, testosterone.

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