CLINICAL, DERMATOLOGICAL, AND HORMONAL CORRELATES OF POLYCYSTIC OVARY SYNDROME: A CASE-CONTROL STUDY IN SOUTHERN PUNJAB, PAKISTAN
Abstract
Background: Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder. This study aimed to assess the clinical, menstrual, obstetric, and endocrine profiles of women with PCOS in comparison to healthy controls ascertained from Southern Punjab, Pakistan.
Materials & Methods: In a cross-sectional case-control study design, 204 PCOS patients and 150 controls were recruited from tertiary care hospitals. PCOS was diagnosed per Rotterdam criteria. Descriptive statistics was employed.
Results: Dermatological manifestations were significantly more prevalent among PCOS cases: hirsutism (Odd ratios, OR: 60.4), acne (OR: 11.2), alopecia (OR: 23.4), seborrhea (OR: 11.7), and acanthosis nigricans (OR: 58.8). Menstrual irregularities like oligomenorrhea and amenorrhea cases were significantly more common among PCOS cases. Abortions and miscarriages were slightly more common among cases, though not statistically significant. Endocrine profiling showed significantly lower FSH levels and higher LH, testosterone, and estradiol levels in PCOS cases. Serum leptin and insulin levels were also significantly elevated, indicating metabolic disturbances. Hirsutism correlated positively with serum testosterone levels in both groups, emphasizing the role of androgen excess in PCOS. Age-stratified analyses of PCOS individuals revealed significant association between waist-and-hip circumference and FSH and LH levels in older age patients.
Conclusions: This study highlights the multifaceted clinical and hormonal disturbances in PCOS and underscores the diagnostic value of dermatological features and endocrine markers. These findings also suggest that PCOS manifestations and hormonal imbalances vary with age, emphasizing the need for age-specific diagnostic and management approaches.
Keywords
Full Text:
PDFReferences
Azziz R, Carmina E, Chen Z, Dunaif A, Laven JS, Legro RS, et al. Polycystic ovary syndrome. Nat Rev Dis Primers. 2016;2:16057. https://doi.org/10.1038/nrdp.2016.57
Dong J, Rees DA. Polycystic ovary syndrome: pathophysiology and therapeutic opportunities. BMJ Med. 2023;2:e000548. https://doi.org/10.1136/bmjmed-2023-000548
Khomami MB, Tehrani FR, Hashemi S, Farahmand M, Azizi F. Of PCOS symptoms, hirsutism has the most significant impact on the quality of life of Iranian women. PLoS One. 2015;10:e0123608. https://doi.org/10.1371/journal.pone.0123608
Islam H, Masud J, Islam YN, Haque FK. An update on polycystic ovary syndrome: a review of the current state of knowledge in diagnosis, genetic etiology, and emerging treatment options. Womens Health. 2022;18:17455057221117966. https://doi.org/10.1177/17455057221117966
Ding T, Hardiman PJ, Petersen I, Wang FF, Qu F, Baio G. The prevalence of polycystic ovary syndrome in reproductive-aged women of different ethnicity: a systematic review and meta-analysis. Oncotarget. 2017;8:96351–8. https://doi.org/10.18632/oncotarget.19180
Mushtaq A, Bibi A, Kausar N. Increased risk of infertility, marital maladjustment and psychological morbidity in PCOS patients of southern Punjab, Pakistan. Pak J Zool. 2022;55:1–8. https://doi.org/10.17582/journal.pjz/20210919130943
Mushtaq A, Bibi A, Malik S, Kausar N. Association of SNPs rs1501299 and rs17300539 in ADIPOQ with serum adiponectin level and risk of polycystic ovarian syndrome (PCOS) in population of Southern Punjab, Pakistan. Pak J Med Sci. 2025;41:1651–7. https://doi.org/10.12669/pjms.41.6.10872
Akram M, Roohi N. Endocrine correlates of polycystic ovary syndrome in Pakistani women. J Coll Physicians Surg Pak. 2015;25:22–6.
Zafar S, Yasmin T, Saeed R, Aslam J, Rafiq T, Saad AB. Prevalence of dyslipidaemia among patients of polycystic ovarian syndrome: a cross-sectional analytical study. Pak J Physiol. 2024;20:19–21. https://doi.org/10.69656/pjp.v20i1.1599
Hussain A, Alam JM. Dyslipidaemia in women with polycystic ovarian syndrome: a case-control study in tertiary care hospital of Karachi. J Pak Med Assoc. 2014;64:1049–52.
Uppal SS, Naveed AK, Majeed A, Shafiq M, Namoos K, Baig S. Complications of obesity in polycystic ovary syndrome: insulin resistance and inflammation. Pak J Med Dent. 2021;10:16–21. https://doi.org/10.36283/PJMD10-2/004
Anjum S, Askari S, Riaz M, Basit A. Clinical presentation and frequency of metabolic syndrome in women with polycystic ovary syndrome: an experience from a tertiary care hospital in Pakistan. Cureus. 2020;12:e11892. https://doi.org/10.7759/cureus.11860
Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81:19–25. https://doi.org/10.1016/j.fertnstert.2003.10.004
Afridi S, Noor S, Shah SJ, Tariq E, Razaq M, Saifullah S. Polycystic ovary syndrome (PCOS): a biochemical and physiological perspective on a common gynaecological disorder in a local hospital of Peshawar. Pak J Health Sci. 2025;6(3):95–101. https://doi.org/10.54393/pjhs.v6i3.2920
Rahim R, Urooj H, Gul H. Frequency of phenotypes and their clinical and hormonal characteristics of polycystic ovarian syndrome. J Coll Physicians Surg Pak. 2024;34:1107–11. https://doi.org/10.29271/jcpsp.2024.09.1107
Ganie MA, Chowdhury S, Malhotra N, Sahay R, Bhattacharya PK, Agrawal S, et al. Prevalence, phenotypes, and comorbidities of polycystic ovary syndrome among Indian women. JAMA Netw Open. 2024;7:e2440583. https://doi.org/10.1001/jamanetworkopen.2024.40583
Mikhael S, Punjala-Patel A, Gavrilova-Jordan L. Hypothalamic-pituitary-ovarian axis disorders impacting female fertility. Biomedicines. 2019;7:5. https://doi.org/10.3390/biomedicines7010005
Al-Jefout M, Alnawaiseh N, Al-Qtaitat A. Insulin resistance and obesity among infertile women with different polycystic ovary syndrome phenotypes. Sci Rep. 2017;7:5339. https://doi.org/10.1038/s41598-017-05717-y
DOI: https://doi.org/10.46903/gjms/24.1.2208
Refbacks
- There are currently no refbacks.
Copyright (c) 2026. Amna Mushtaq, Asia Bibi, Muhammad Asim Iqbal Qureshi, Faheem Riaz, Sajid Malik, Nahid Kausar

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Gomal Medical College, Daraban Road, Dera Ismail Khan, Pakistan
ISSN: 1819-7973, e-ISSN: 1997-2067
Website: https://www.gmcdikhan.edu.pk
Phone: +92-966-747373


