Phenotypic spectrum of polycystic ovary syndrome in a tertiary care rural hospital in Eastern India

Background: PCOS is a common, complicated endocrine disorder affecting women of reproductive age causing wide-spectrum of clinical, metabolic and hormonal abnormalities whose characteristics are poorly understood. This research will investigate the phenotypic prevalence of PCOS as well as clinical, hormonal and metabolic aspects to identify risks and therapeutic requirements. Methods: The Rotterdam criteria were used to classify 204 women with PCOS into four phenotypes: A (hyperandrogenism + oligo/anovulation + polycystic ovaries), B (hyperandrogenism + oligo/anovulation), C (hyperandrogenism + polycystic ovaries) and D (oligo/anovulation + polycystic ovaries). BMI, waist circumference, hip circumference, waist-to-hip ratio and clinical features (menstrual abnormalities, acanthosis nigricans) were examined. To compare the phenotypes, luteinizing hormone, follicle-stimulating hormone, testosterone and metabolic indicators (lipid profiles, glucose metabolism parameters) were examined. The phenotypes were also examined for the prevalence of metabolic syndrome. Results: A (58.33%) was the most prevalent phenotype, followed by D (32.84%), C (4.90%) and B (3.43%). Phenotype A had the highest BMI and most menstrual abnormalities and also the highest LH/FSH ratio and the highest testosterone, indicating a severe endocrine disorder. Phenotype A also had the worst lipid profile and the highest metabolic syndrome (24.37%). Conclusion: Phenotype A is the most severe form of PCOS, characterized by clinical, metabolic and hormonal abnormalities and increases the risk of cardiovascular and metabolic problems. These data suggest that PCOS therapy should be phenotype-specific to address the risks and health problems of each phenotype and treatment individualised.