ESPE Abstracts

Introduction: The prevalence of PCOS in adolescents and young women was established at 4.3%. Whether women with a history of ICPP are at increased risk for PCOS is still controversial. There is no clear evidence that ICPP girls treated with GnRH analogues (GnRHa) are more likely to develop PCOS than their age-matched peers.

Objectives: To assess the prevalence of PCOS in adolescents with a history of ICPP and further compared the prevalence with ICPP girls who have not received GnRHa treatment.

Materials and Methods: A retrospective cohort study was performed. PATIENTS: 142 post-menarche girls with a history of ICPP diagnosed between 2000 and 2012 from the outpatient Endocrine Division. Girls were evaluated at gynaecological age (GA) ≥ 2.5 years. Patients with incomplete clinical reports were excluded (n=48). Data collected included: age at menarche, menstrual cycle characteristics, body mass index (BMI), and clinical signs of hyperandrogenism (HA): hirsutism (Ferriman-Gallwey score >8) and severe acne. Serum total and free testosterone levels were determined. PCOS diagnosis was defined by criteria for the adolescent population: > 2.5 years of GA with cycle disorder, clinical and biochemical hyperandrogenism. Other endocrine disorders were excluded. After the whole cohort analysis, patients were analyzed with respect to whether or not they received GnRHa treatment. STATISTICS: Data are expressed as mean ± standard deviation (SD). Mann-Whitney U-test and Fisher´s exact test were used accordingly.

Results: Mean ± SD chronological age (n=94) was 15.6± 1.9 years, and 63 were treated with GnRHa. The mean BMI was 23.6±3.8. Menstrual disorders were found in 27/94 girls (28.7 %). Clinical HA was present in 34/94 (36%). Biochemical HA was found in 22/94 (23.4%). Eleven out of 94 patients (11.7%) met the diagnosis criteria for PCOS. There were no differences in BMI or in the frequency of menstrual dysfunction, clinical hyperandrogenism or hyperandrogenemia between treated and untreated patients. The relative risk (RR) of developing PCOS was 2.5 (95 % CI 1.25-5.24) in our cohort with a history of ICPP compared to a historic population of healthy adolescents. The RR was not higher between the group of patients who received treatment with GnRHa and those who did not.

Conclusion: Adolescent girls with a history of ICPP have an increased risk of PCOS. This risk seems not to be related to GnRHa treatment.