多嚢胞性卵巣症候群の頻度からみた月経周期異常・無月経を伴う思春期女性における内分泌学的特異性の考察

This study was performed to clarify whether pubertal women with menstrual cycle irregularity and/or amenorrhea have characteristic ovarian morphology and endocrinologic abnormalities. The subjects consisted of 68 patients aged 11-24 years, including 35 women in puberty aged 11-19years. Somatic changes, mainly development of the breast and pubic hair, were evaluated using the classification of pubertal sequential events proposed by Tanner. We detected morphologic changes of ovaries by transvaginal ultrasonography and measured luteinizing hormone (LH), follicle-stimulating hormone (FSH) and testosterone at the same time. For evaluation of the frequency of PCOS in pubertal women as compared with adult women with the menstrual cycle irregularity and /or amenorrhea, we examined the same study with 27 women in puberty aged 11-19 years and 30 adult women with the same disorders. Menstrual cycle irregularity and/or amenorrhea were complained of many patients (68%). Twelve of the 27 pubertal women with these abnormalities aged 11-19 years had significantly higher LH/FSH ratio (2.86±1.58; p<0.03, vs control) and testosterone level (29.2± 15.4ng/dl; p<0.05, vs control) than in contol women in puberty without the same abnormalities, and polycystic ovaries were identified on the transvaginal ultrasonography in these 12 pubertal women at the same time. These 12 women were therefore diagnosed with polycystic ovary syndrome (PCOS). We then evaluated the frequency of occurrence of PCOS in pubertal women with the menstrual cycle irregularity and /or amenorrhea compared with that in adult women with the same disorders. Five of 30 adult women with menstrual cycle irregularity and/or amenorrhea were diagnosed with PCOS. These results suggest that women in puberty with menstrual cycle irregularity and/or amenorrhea have a significantly higher frequency of morphological and endocrinological abnormalities diagnosed with PCOS than adult women with the same abnormalities (chi-square statistic method, a =0.05). Thus, screening for menstrual disorders in pubertal women, it is helpful to determine whether PCOS exists. [Adv. Obstet. Gynecol., 52 (6): 771-777, 2000 (H.12.11)]