Reproductive Hormones and Anthropometry: A Follow-Up of PCOS and Controls from Perimenopause to Older Than 80 Years

Abstract

Context: There is a lack of knowledge about hormonal and anthropometric changes in women with polycystic ovary syndrome (PCOS) after the menopause. Objective: This work aimed to study reproductive hormones and anthropometry in women with PCOS older than 80 years. Design and Setting: This prospective cohort study was conducted at a university hospital. Patients: A well-defined cohort of women with PCOS, previously examined in 1987 and 2008 (21 years) was reexamined in 2019 (11 years). Of the original cohort (n=37), 22 women were still alive and 21 (age range, 72-91 years) participated. Comparisons were made with age-matched controls (n=55) from the original control cohort (body mass index [BMI] similar to PCOS women). The results were compared with results from 1987 and 2008. Interventions: Hormonal measurements and a physical examination were performed. Main Outcome Measures: Follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, sex hormone-binding globulin (SHBG), free androgen index (FAI), hirsutism score, BMI, and waist to hip ratio (WHR) were measured. Results: At mean age 81 years, FSH levels were lower in women with PCOS (50 vs 70 IU/L) who were still more hirsute than controls (33% vs 4%). No differences were found in FAI, testosterone, SHBG or LH levels, BMI, or WHR. From perimenopausal age until the present age, levels of testosterone and FAI continued to decline in women with PCOS. SHBG levels continued to increase with age. FSH had not changed over time during the last 11 years. Conclusions: Women with PCOS at age 72 to 91 had lower FSH levels, remained clinically hyperandrogenic, and had similar FAI and body composition as controls.