Psychosocial aspects of women with polycystic ovary syndrome from south India.

BACKGROUND: Polycystic ovary syndrome (PCOS), though initially manifesting with reproductive and cosmetic symptoms is a harbinger of insulin resistance syndrome. It is associated with psychological distress in both management as well as in its etiology. There are no Indian studies on psychological stress in women with PCOS. METHODS: Ninety nine women who presented with PCOS to the Endocrinology clinic were administered Goldberg's GHQ 28 (General Health Questionnaire) to assess psychological status, along with clinical, hormonal and ultrasound evaluation. RESULTS: Fifty four percent had a GHQ28 score >8. Among them 38% had a family size <4, 72% had obesity, 70% had hirsutism, 72% had a waist circumference >88 cm and 69% had a F/G score >4 . All these variables were statistically significant; p < 0.05 using Chi-square test. CONCLUSION: Women presenting with PCOS had increased psychological distress, which was related to smaller size of family, and more severe physical manifestations of the condition.

Late onset adrenal hyperplasia due to 3 beta-hydroxy-delta 5-steroid dehydrogenase deficiency in north Indian hirsute women.

The presence of late onset 3 beta-hydroxy steroid dehydrogenase (3 beta-HSD) type of congenital adrenal hyperplasia was studied in 58 north Indian hirsute women. The age range of these patients was 15 to 42 yr. Fifty two per cent of these patients had body mass index > 25. Basal serum testosterone, luteinizing hormone, follicle stimulating hormone, dehydroepiandrosterone sulphate (DHEAS), and 17 hydroxy progesterone (17 OHP) were estimated. All the patients underwent adrenocorticotropin (ACTH) stimulation test after an overnight dexamethasone suppression for the estimation of DHEAS, 17 OHP, and 17 hydroxy pregnenolone (delta 5-17p). Five (8.6%) hirsute women showed an exaggerated 17 OHP response to ACTH indicating 21-hydroxylase deficiency. Eight (13.8%) hirsute women had elevated basal DHEAS and ACTH-stimulated DHEAS as well as delta 5-17P responses indicative of 3 beta-HSD deficiency. In one patient hirsutism was the presenting manifestation of tumoural hyperandrogenism. Our findings indicate the presence of both 21-hydroxylase and 3 beta-HSD deficiency in north Indian hirsute women, with, 3 beta-HSD deficiency being the major cause of hirsutism in this population.