Endocrine Abnormalities in Adolescents with Menstrual Disorders



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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  1. 1.

    Parker MA, Sneddon AE, Arbon P. The menstrual disorder of teenagers (MDOT) study: determining typical menstrual patterns and menstrual disturbance in a large population-based study of Australian teenagers. BJOG. 2010;117(2):185–92.

    CAS  Article  PubMed  Google Scholar 

  2. 2.

    Kakuno Y, Amino N, Kanoh M, et al. Menstrual disturbances in various thyroid diseases. Endocr J. 2010;57(12):1017–22.

    Article  PubMed  Google Scholar 

  3. 3.

    Lee DY, Oh YK, Yoon BK, et al. Prevalence of hyperprolactinemia in adolescents and young women with menstruation-related problems. Am J Obstet Gynecol. 2012;206(3):213–5.

    Article  PubMed  Google Scholar 

  4. 4.

    Nidhi R, Padmalatha V, Nagarathna R, et al. Prevalence of polycystic ovarian syndrome in Indian adolescents. J Pediatr Adolesc Gynecol. 2011;24(4):223–7.

    Article  PubMed  Google Scholar 

  5. 5.

    Rigon F, De Sanctis V, Bernasconi S, et al. Menstrual pattern and menstrual disorders among adolescents: an update of the Italian data. Ital J Pediatr. 2012;38:38.

    Article  PubMed  PubMed Central  Google Scholar 

  6. 6.

    Rosenfield RL. Clinical review: adolescent anovulation: maturational mechanisms and implications. J Clin Endocrinol Metab. 2013;98(9):3572–83.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  7. 7.

    Chhabra S, Venkatraman S. Menstrual dysfunction in rural young women and the presence of polycystic ovarian syndrome. J Obstet Gynaecol. 2010;30(1):41–5.

    CAS  Article  PubMed  Google Scholar 

  8. 8.

    Chung PW, Chan SS, Yiu KW, et al. Menstrual disorders in a paediatric and adolescent gynaecology clinic: patient presentations and longitudinal outcomes. Hong Kong Med J. 2011;17(5):391–7.

    CAS  PubMed  Google Scholar 

  9. 9.

    Zegeye DT, Megabiaw B, Mulu A. Age at menarche and the menstrual pattern of secondary school adolescents in northwest Ethiopia. BMC Womens Health. 2009;9:29.

    Article  PubMed  PubMed Central  Google Scholar 

  10. 10.

    Abraham R, Srinivasa Murugan V, Pukazhvanthen P, et al. Thyroid disorders in women of Pondicherry. Indian J Clin Biochem. 2009;24(1):52–9.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  11. 11.

    Joshi B, Mukherjee S, Patil A, et al. A cross-sectional study of polycystic ovarian syndrome among adolescent and young girls in Mumbai, India. Indian J Endocrinol Metab. 2014;18(3):317–24.

    Article  PubMed  PubMed Central  Google Scholar 

  12. 12.

    Chen X, Yang D, Mo Y, et al. Prevalence of polycystic ovary syndrome in unselected women from southern China. Eur J Obstet Gynecol Reprod Biol. 2008;139(1):59–64.

    Article  PubMed  Google Scholar 

  13. 13.

    Hickey M, Doherty DA, Atkinson H, et al. Clinical, ultrasound and biochemical features of polycystic ovary syndrome in adolescents: implications for diagnosis. Hum Reprod. 2011;26(6):1469–77.

    CAS  Article  PubMed  Google Scholar 

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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).

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Corresponding author

Correspondence to Haritha Sagili.

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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.

Additional information

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

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  • Thyroid disorders
  • Hyperprolactinemia
  • Hyperandrogenism
  • PCOS
  • Adolescents