Cross-sectional analysis of the effects of age on the hormonal, metabolic, and ultrasonographic features and the prevalence of the different phenotypes of polycystic ovary syndrome

Objective To assess the effects of age on the hormonal, metabolic, and ultrasonographic features of polycystic ovary syndrome (PCOS). Design Observational study. Setting University department of obstetrics and gynecology. Patient(s) Patients with PCOS (n = 1,212) and healthy women (n = 254). Intervention(s) None. Main Outcome Measure(s) Differences in the hormonal, metabolic, and ultrasonographic features of PCOS between age groups. Result(s) A progressive decline in circulating androgens was observed with advancing age. Patients 21–30 years old had lower plasma glucose and insulin levels, lower area under the oral glucose tolerance test curve and lower homeostasis model assessment of insulin resistance index, and higher glucose/insulin and quantitative insulin sensitivity check index than patients 31–39 years old. The prevalence of PCOS phenotypes changed with age. More specifically, the distribution of the phenotypes did not differ substantially between patients ≤20 years old and patients 21–30 years old. However, a decline in the prevalence of phenotype 1 (characterized by anovulation, hyperandrogenemia, and polycystic ovaries) and an increase in the prevalence of phenotype 4 (characterized by anovulation and polycystic ovaries without hyperandrogenemia) were observed in patients 31–39 years old. Conclusion(s) In women with PCOS, hyperandrogenemia appears to diminish during reproductive life whereas insulin resistance worsens.