Endocrine Abnormalities in Adolescents with Menstrual Disorders

• Published in: Journal of obstetrics and gynaecology of India 2018-02, Vol.68 (1), p.58-64
• Main Authors: Rajiwade, Siddhesh R., Sagili, Haritha, Soundravally, R., Subitha, L.
• Format: Article
• Language: English
• Subjects: Gynecology; Medicine; Medicine & Public Health; Obstetrics/Perinatology/Midwifery; Original; Original Article
• ISSN: 0971-9202; 0975-6434
• DOI: 10.1007/s13224-017-1035-y

Purpose 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. Methods 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. Results 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. Conclusions 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.