open access
Is polycystic ovarian syndrome and insulin resistance associated with abnormal uterine bleeding in adolescents?
, 2, 3, 1, 4, 1
Affiliations- Woman’s Health Chair, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
- Department and Clinic of Gynaecology and Obstetrics, Wroclaw Medical University, Wroclaw, Poland
- Health Promotion and Obesity Management Unit, Department of Pathophysiology, Faculty of Medicine, Medical University of Silesia, Katowice, Poland
- Department of the Internal Disease, Dermatology and Allergy, European Center of Diagnosis and Treatment of Urticaria, School of Medicine in Zabrze, Medical University of Silesia, Katowice, Poland
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Abstract
Objectives: The aim of the study was to determine if adolescents with juvenile bleeding had polycystic ovarian syndrome (PCOS) and insulin resistance.
Material and methods: The study was conducted in a group of 43 females aged 12–18 years, diagnosed with juvenile menorrhagia, and 37 healthy female adolescents aged 12–18 years. The study was conducted during the early follicular phase of the menstrual cycle. Menstrual cycle disturbances, acne and hirsutism were recorded. Ultrasound scan determining the condition of the ovaries was conducted. Laboratory tests of the glucose level, cholesterol, LDL and HDL cholesterol and triglycerides fraction, DHEAS, FSH, LH, insulin, SHGB, total testosterone, androstenedione, and free testosterone have been established.
Results: The occurrence of regular menstrual cycles (30.23%, p = 0.006) was significantly lower in the juvenile bleeding group. Also, secondary amenorrhea was significantly more likely to be recognized in this group of females (p = 0.03). The concentration of FSH was considerably lower (p = 0.0002) in the group of adolescents with AUB.
Conclusions: Adolescents with abnormal uterine bleeding (AUB) are often diagnosed with secondary amenorrhea, and PCOS. The group with a diagnosis of juvenile bleeding was also diagnosed with higher rates of insulin resistance.
Abstract
Objectives: The aim of the study was to determine if adolescents with juvenile bleeding had polycystic ovarian syndrome (PCOS) and insulin resistance.
Material and methods: The study was conducted in a group of 43 females aged 12–18 years, diagnosed with juvenile menorrhagia, and 37 healthy female adolescents aged 12–18 years. The study was conducted during the early follicular phase of the menstrual cycle. Menstrual cycle disturbances, acne and hirsutism were recorded. Ultrasound scan determining the condition of the ovaries was conducted. Laboratory tests of the glucose level, cholesterol, LDL and HDL cholesterol and triglycerides fraction, DHEAS, FSH, LH, insulin, SHGB, total testosterone, androstenedione, and free testosterone have been established.
Results: The occurrence of regular menstrual cycles (30.23%, p = 0.006) was significantly lower in the juvenile bleeding group. Also, secondary amenorrhea was significantly more likely to be recognized in this group of females (p = 0.03). The concentration of FSH was considerably lower (p = 0.0002) in the group of adolescents with AUB.
Conclusions: Adolescents with abnormal uterine bleeding (AUB) are often diagnosed with secondary amenorrhea, and PCOS. The group with a diagnosis of juvenile bleeding was also diagnosed with higher rates of insulin resistance.
Keywords
abnormal uterine bleeding; polycystic ovarian syndrome; hyperandrogenism; insulin resistance
About this articleTitle
Is polycystic ovarian syndrome and insulin resistance associated with abnormal uterine bleeding in adolescents?
Journal
Issue
Article type
Research paper
Pages
262-269
Published online
2019-05-31
Page views
2714
Article views/downloads
1809
DOI
Pubmed
Bibliographic record
Ginekol Pol 2019;90(5):262-269.
Keywords
abnormal uterine bleeding
polycystic ovarian syndrome
hyperandrogenism
insulin resistance
Authors
Ewa Urbanska
Lidia Hirnle
Magdalena Olszanecka-Glinianowicz
Violetta Skrzypulec-Plinta
Agnieszka Skrzypulec-Frankel
Agnieszka Drosdzol-Cop
References (32)- Deligeoroglou E, Tsimaris P. Menstrual disturbances in puberty. Best Pract Res Clin Obstet Gynaecol. 2010; 24(2): 157–171.
- Skrzypulec-Plinta V, Drosdzol-Cop A. Krwawienia młodocianych u dziewcząt – diagnostyka, postępowanie. In:, Radowicki S. (eds.). Wybrane zagadnienia z ginekologii dziecięcej i dziewczęcej. Medical Project. ; 2011: 133–144.
- Skrzypulec-Plinta V, Drosdzol-Cop A. Krwawienia młodocianych. Prz Menopauze. 2010; 4: 228–230.
- Jakimiuk AJ, Grzybowski W, Beta J. [Dysfunctional uterine bleeding--diagnostics and treatment]. Ginekol Pol. 2008; 79(4): 254–258.
- Wilkson JP, Kadir RA. Management of abnormal uterine bleeding in adolescents. J Pediatr Adolesc Gynecol. 2010; 23: 22–30.
- Holland-Hall C. Obfite krwawienia miesiączkowe nastolatek – norma czy zaburzenie? Ginek Dypl. 2013; 15: 65–72.
- Committee on Practice Bulletins—Gynecology. Practice bulletin no. 128: diagnosis of abnormal uterine bleeding in reproductive-aged women. Obstet Gynecol. 2012; 120(1): 197–206.
- LaCour DE, Long DN, Perlman SE. Dysfunctional uterine bleeding in adolescent females associated with endocrine causes and medical conditions. J Pediatr Adolesc Gynecol. 2010; 23(2): 62–70.
- Wood PL, Bauman D. Gynaecological issues affecting the obese adolescent. Best Pract Res Clin Obstet Gynaecol. 2014; 20: 1–13.
- Szydlarska D, Grzesiuk W, Bar-Andziak E. Kontrowersje wokół patogenezy zespołu policystycznych jajników. Endokr Otyłość. 2010; 6: 141–146.
- Musmar S, Afaneh A, Mo'alla H. Epidemiology of polycystic ovary syndrome: a cross sectional study of university students at An-Najah national university-Palestine. Reprod Biol Endocrinol. 2013; 11: 47.
- Radomski D, Orzechowska A, Barcz E. [Present conceptions of etiopathogenesis of polycystic ovary syndrome]. Ginekol Pol. 2007; 78(5): 393–399.
- Sokkary N, Dietrich JE. Management of heavy menstrual bleeding in adolescents. Curr Opin Obstet Gynecol. 2012; 24(5): 275–280.
- Gursel T, Biri A, Kaya Z, et al. The frequency of menorrhagia and bleeding disorders in university students. Pediatr Hematol Oncol. 2014; 31(5): 467–474.
- Altintas KZ, Dilbaz B, Cirik DA, et al. The incidence of metabolic syndrome in adolescents with different phenotypes of PCOS. Ginekol Pol. 2017; 88(6): 289–295.
- Ozegowska KE, Pawelczyk LA. The role of insulin and selected adipocytokines in patients with polycystic ovary syndrome (PCOS) - a literature review. Ginekol Pol. 2015; 86(4): 300–304.
- American College of Obstetrician and Gynecologists. Committee on Adolescent Healt Care. Committee Option Number 349. Miesiączkowanie w wieku dziecięcym i w okresie dojrzewania: cykl miesiączkowy jako wyznacznik stanu organizmu. Ginek Dypl. 2009; 11: 83–87.
- Skałba P. Diagnostyka i leczenie zaburzeń endokrynologicznych w ginekologii. Medycyna Praktyczna, Kraków 2014: 31–54, 57–61, 68–85, 250–270.
- Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group, Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004; 19(1): 41–47.
- Esmaeilzadeh S, Delavar MA, Amiri M, et al. Polycystic ovary syndrome in Iranian adolescents. Int J Adolesc Med Health. 2014; 26(4): 559–565.
- Rackow BW. Polycystic ovary syndrome in adolescents. Curr Opin Obstet Gynecol. 2012; 24(5): 281–287.
- Drosdzol-Cop A, Sidło-Stawowy A, Sajdak D, et al. [Diagnosing polycystic ovary syndrome in adolescent girls]. Ginekol Pol. 2014; 85(2): 145–148.
- Altay MM, Haberal A. Abnormal uterine bleeding in adolescents: treatment with combined oral contraceptive pills is effective even in hospitalized patients with bleeding disorders. Turk J Med Sci. 2008; 38: 431–435.
- Bouzas IC, Cader SA, Leão L, et al. Menstrual cycle alterations during adolescence: early expression of metabolic syndrome and polycystic ovary syndrome. J Pediatr Adolesc Gynecol. 2014; 27(6): 335–341.
- Shah B, Parnell L, Milla S, et al. Endometrial thickness, uterine, and ovarian ultrasonographic features in adolescents with polycystic ovarian syndrome. J Pediatr Adolesc Gynecol. 2010; 23(3): 146–152.
- West S, Lashen H, Bloigu A, et al. Irregular menstruation and hyperandrogenaemia in adolescence are associated with polycystic ovary syndrome and infertility in later life: Northern Finland Birth Cohort 1986 study. Hum Reprod. 2014; 29(10): 2339–2351.
- Pinola P, Lashen H, Bloigu A, et al. Menstrual disorders in adolescence: a marker for hyperandrogenaemia and increased metabolic risks in later life? Finnish general population-based birth cohort study. Hum Reprod. 2012; 27(11): 3279–3286.
- Başaran HO, Akgül S, Kanbur NO, et al. Dysfunctional uterine bleeding in adolescent girls and evaluation of their response to treatment. Turk J Pediatr. 2013; 55(2): 186–189.
- Vrbíková J, Zamrazilová H, Sedláčková B, et al. Metabolic syndrome in adolescents with polycystic ovary syndrome. Gynecol Endocrinol. 2011; 27(10): 820–822.
- Li L, Chen X, He Z, et al. Clinical and metabolic features of polycystic ovary syndrome among Chinese adolescents. J Pediatr Adolesc Gynecol. 2012; 25(6): 390–395.
- Fulghesu A, Magnini R, Portoghese E, et al. Obesity-related lipid profile and altered insulin incretion in adolescents with polycystic ovary syndrome. J Adolesc Health. 2010; 46(5): 474–481.
- Nidhi R, Padmalatha V, Nagarathna R, et al. Prevalence of polycystic ovarian syndrome in Indian adolescents. J Pediatr Adolesc Gynecol. 2011; 24(4): 223–227.
