Women with polycystic ovary syndrome wedge resected in 1956 to 1965: a long-term follow-up focusing on natural history and circulating hormones

Eva Dahlgren; Saga Johansson; Göran Lindstedt; Folke Knutsson; Anders Odén; Per Olof Janson; Lars-Åke Mattson; Nils Crona; Per-Arne Lundberg

doi:10.1016/s0015-0282(16)54892-4

PMOS / PCOS Long Term Health

Women with polycystic ovary syndrome wedge resected in 1956 to 1965: a long-term follow-up focusing on natural history and circulating hormones

Dahlgren E, Johansson S, Lindstedt G, Knutsson F, Odén A, Janson PO, Mattson LA, Crona N, Lundberg PA

Published March 1992 Fertility and Sterility, 57(3), 505-513

DOI 10.1016/s0015-0282(16)54892-4 PMID 1740195

RRM Academy Synopsis

Swedish PCOS cohort had more diabetes and hypertension near menopause

A Swedish follow-up of 33 women with polycystic ovary syndrome (PCOS), operated on in 1956 to 1965, and 132 women without it found 39 out of 100 women with PCOS took treatment for high blood pressure, against 11 out of 100 others. Diabetes was also more common. Among the women with PCOS, irregular periods became less common over time.

Key Findings

Treated hypertension: 39% of the women with PCOS against 11% of referents (P < 0.001). Diagnosed diabetes mellitus: 15% against 2.3% (P < 0.05).
Periods 35 days apart or longer affected 81% of the women with PCOS before surgery, 61% after surgery and 28% during the latest decade.
Hirsutism affected 61% of the women with PCOS and 11% of referents (P < 0.001). Hysterectomy had occurred in 21% against 7% (P < 0.01).
Infertility clinic attendance was 70% among the women with PCOS against 11% among referents (P < 0.001). Childlessness was 24% against 16%, a difference that was not significant.

Interpretation

This long-term follow-up study compared 33 women who had wedge resection for PCOS with 132 women from the same city who did not have PCOS. The authors note that the women were selected by ovarian tissue findings, which may have included more severe cases of PCOS. The findings support larger studies of hypertension and diabetes risk in women with PCOS.

RRM Context

Restorative Reproductive Medicine treats PCOS, now also called PMOS (polyendocrine metabolic ovarian syndrome), as having both an ovulation side and a metabolic side. These findings support that view. Root-cause care checks both sides.

Our editorial summary of this paper, not the article's abstract.

Abstract

Objective

To determine if the hormonal imbalance in women with polycystic ovary syndrome (PCOS) continues into and after menopause and to analyze factors constituting an increased risk for developing metabolic disorders.

Design

The study was a transectional retrospective cohort follow-up of patients with PCOS.

Setting

The women with PCOS were recruited from hospital clinics, and referents were randomized from a population study of women.

Participants

Thirty-three women ages 40 to 59 years with ovarian histopathology typical of PCOS at wedge resection 22 to 31 years previously; 132 age-matched referents were analyzed.

Main Outcome Measures

Clinical data were collected via a questionnaire supplemented with an interview in connection to a clinical examination that also included fasting venous sampling.

Results

Infertility, hirsutism, and oligomenorrhea were more common among the subjects with PCOS, but there was a considerable spontaneous restitution of cyclic regularity with time. Women with PCOS were more often hysterectomized and entered menopause later compared with referents. The hormone data show a typical profile for PCOS. Compared with referents women with PCOS showed marked increase in prevalence of central obesity, higher basal serum insulin concentrations, and a higher prevalence of diabetes mellitus and hypertension.

Conclusion

Perimenopausal women with PCOS have an increased morbidity in hypertension and diabetes mellitus that adds to the classic symptoms, such as anovulation, hirsutism, and infertility.

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PMOS / PCOS: Causes, Diagnosis, and Treatment

Topics

PMOS / PCOS › Long Term Health › Metabolic Risk · Reproductive Endocrinology › Ovarian Hormones › Androgens · Perimenopause and Menopause › Long Term Health › Cardiovascular Health

Eva Dahlgren, Saga Johansson, Göran Lindstedt, Folke Knutsson, Anders Odén, Per Olof Janson, Lars-Åke Mattson, Nils Crona, Per-Arne Lundberg

E Dahlgren, S Johansson, G Lindstedt, F Knutsson, A Odén, P Janson, L Mattson, N Crona, P Lundberg

PMID 1740195 1740195 DOI 10.1016/s0015-0282(16)54892-4 10.1016/s0015-0282(16)54892-4 Dahlgren et al. 1992, Dahlgren 1992

Keywords

Adult, Androgens/blood, Body Mass Index, Estradiol/blood/therapeutic Use, Estrogen Replacement Therapy, Estrone/blood, Female, Fertility, Follicle Stimulating Hormone/blood, Follow-Up Studies, Humans, Insulin/blood, Luteinizing Hormone/blood, Menstruation, Middle Aged, Polycystic Ovary Syndrome/blood/physiopathology/surgery, Prolactin/blood, Thyrotropin/blood, Androgens, Insulin, Estrone, Estradiol, Prolactin, Luteinizing Hormone, Follicle Stimulating Hormone, Thyrotropin

Women with polycystic ovary syndrome wedge resected in 1956 to 1965: a long-term follow-up focusing on natural history and circulating hormones

Swedish PCOS cohort had more diabetes and hypertension near menopause

Key Findings

Interpretation

RRM Context

Abstract

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Topics

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Keywords