To look for endocrine abnormalities like thyroid disorders, hyperprolactinemia, hyperandrogenism and PCOS among adolescents with menstrual disorders and to compare the above endocrine status with those without menstrual disorders.
This was a case–control study carried out in adolescent girls aged 10–19 years in gynecology outpatient department of a tertiary care hospital. Sample of venous blood (5 ml) was taken for hormonal studies as clinically indicated—thyroid function test, serum prolactin, total testosterone, which were analyzed by chemiluminescence system.
Oligomenorrhea was the most common menstrual abnormality in our study, the prevalence being 61.0% in cases followed by primary amenorrhea (16.4%). Thyroid dysfunction was found in 13.6% girls with menstrual disorders compared to 3.5% in those without menstrual disorders, and this was statistically significant (p = 0.006). Biochemical hyperandrogenism was seen in 9.04% cases compared to 0.7% controls (p = 0.001). The overall prevalence of hyperprolactinemia was 0.94%, and there was no statistically significant difference in girls with and without menstrual disorders. The prevalence of PCOS was 12.4% in the study population and 22.6% cases. Oligomenorrhea and PCOS were the most prevalent phenotypes in 52.5% of PCOS girls. No endocrine abnormality was detected in cases of polymenorrhea, hypomenorrhea and intermenstrual bleeding.
Although immaturity of hypothalamic pituitary ovarian axis is considered to be the most common cause of menstrual irregularities in adolescent girls, endocrine abnormalities, namely thyroid dysfunction and hyperandrogenism, may be responsible in some cases, thus warranting further evaluation.
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We acknowledge Dean research, JIPMER for granting intramural fund of Rs. 1 lakh for PG Project utilized for hormone kits, reagents, calibrators (Circular No. Edn. 7(1)/2012, dated 28.9.2012).
Conflict of interest
All authors declare that they have no conflict of interest.
Informed consent in studies with human subjects
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Declaration of Helsinki of 1975, as revised in 2008. Informed consent was obtained from all patients for being included in the study.
Dr. Siddhesh R. Rajiwade is a Senior Resident in the Department of Obstetrics and Gynecology, JIPMER, Puducherry, 605006 India; Dr. Haritha Sagili is a Additional Professor in the Department of Obstetrics and Gynecology, JIPMER, Puducherry, 605005 India; Dr. R. Soundravally is a Additional Professor in the Department of Biochemistry, JIPMER, Puducherry, 605006 India; Dr. L. Subitha is a Assistant Professor, Department of Preventive and Social medicine, JIPMER, Puducherry, 605006 India.
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Rajiwade, S.R., Sagili, H., Soundravally, R. et al. Endocrine Abnormalities in Adolescents with Menstrual Disorders. J Obstet Gynecol India 68, 58–64 (2018). https://doi.org/10.1007/s13224-017-1035-y
- Thyroid disorders