Diagnosing polycystic ovary syndrome at a tertiary level hospital in Latin America

Abstract

Polycystic ovary syndrome (PCOS) is the most common neuroendocrine disorder in women of reproductive age. There is little consensus on the diagnosis of this syndrome, which affects both the number of cases that are diagnosed and the respective consequences. The aim of the present study was to evaluate the degree to which currently established criteria for diagnosing polycystic ovary syndrome are followed at a tertiary-level hospital in Colombia. Cross-sectional, observational, analytical study of patients diagnosed with PCOS between 2012 and 2019. A statistical analysis was performed based on information obtained from clinical histories, using frequencies and percentages for categorical variables and measures of central tendency for continuous variables. A total of 66 patients were included in the study, of which 69.69% (n = 46) sought medical care for abnormal uterine bleeding, 64.9% (n = 37) were found to be overweight or obese, 39.39% (n = 26) had clinical hyperandrogenism and 84.84% (n = 56) presented imaging findings compatible with polycystic ovaries. The ultrasound description was incomplete in the majority of cases. A Ferriman-Gallwey score was used to evaluate 7.57% (n = 5) of the patients, 53.03% (n = 35) were diagnosed without a complete or any exclusion of differential pathologies and 34.85% (n = 23) of the women were diagnosed with PCOS in accordance with currently established criteria. The main causes of the high frequency of diagnosing PCOS in a manner that did not accord with current criteria may have been not having excluded differential pathologies, not applying the established scale for objectively evaluating hirsutism and a lack of specifying follicular counts in imaging reports.