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Thyroid function tests in polycystic ovarian syndrome

Samiksha Ganvir, Anagha Vinay Sahasrabuddhe, Shailesh Umakant Pitale.


Background: Polycystic ovarian syndrome (PCOS) or polycystic ovarian disease (PCOD) is the most common endocrine problem in young females with chronic anovulatory cycles occurring in 5-10% of reproductive women. PCOS is viewed as a heterogeneous disorder of multifactorial etiology also associated with increased metabolic and cardiovascular risk factors. Both PCOD and thyroid dysfunction have multiple common presentations and both have profound effect on fertility and reproductive biology. Hypothyroidism can initiate, maintain or worsen PCOD.

Aims and Objectives: This study has been contemplated to investigate the prevalence of thyroid disorders in PCOS patients from Central India.

Materials and Methods: Female patients in the age group between 18 and 30 years meeting Rotterdam criteria for the diagnosis of PCOS were included in the study. The patients were asked to report in fasting state for the following investigations: Fasting blood sugars, fasting insulin levels, serum luteinizing hormone (LH), follicle stimulating hormone (FSH), thyroid stimulating hormone (TSH), serum testosterone, dehydroepiandrosterone, and serum prolactin were done. FSH and LH were done on the 2nd or 3rd day of menstrual cycle. Gynecological ultrasound was done to assess ovarian condition and presence or absence of multiple cysts.

Results: LH/FSH ratio of more than 2 was found in 60% of the cases, 41 subjects (68%) were insulin resistant. Raised serum testosterone was found in 64% of the cases. The mean TSH level in subjects was 4.219333 ± 1.877632. Subclinical hypothyroidism was seen in 16 (26.6%) cases and overt hypothyroidism in 12 (20%) cases. Total thyroid dysfunction (clinical and subclinical) was seen in 28 (46.66%) cases.

Conclusion: The prevalence of thyroid dysfunction in PCOS is very high. All patients with PCOS should be screened for thyroid dysfunction.

Key words: Polycystic Ovarian Syndrome; Thyroid Dysfunction; Ferriman–Gallwey Score; Hirsuitism; Rotterdam Classification

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