Women With Polycystic Ovary Syndrome Gain Regular Menstrual Cycles When Ageing

Abstract

Based on observations that ovarian follicles are gradually lost with advancing age, this study attempted to learn whether women with polycystic ovary syndrome (PCOS) who had been oligomenorrheic or amenorrheic achieved regular menstrual cycles as they became older. A total of 346 such women, aged 30 years and older, were interviewed. Their first visit had been an average of 12 years earlier, when the mean age was 26.7 years. A questionnaire was used when interviewing these women by telephone to establish the prevalent pattern of menstrual cycles. Irregular cycles were those occurring at intervals longer than 6 weeks. Exclusion of women who had used oral contraception or taken hormones for infertility left 205 subjects, 60 percent of whom had cycles shorter than 6 weeks. Age correlated strongly and inversely with cycle length; the proportion of women with regular cycles rose from 41 percent at age 30 to 35 years to 100 percent in those aged 51 to 55 years (Fig. 1). Regular cycles were described by 58 percent of women whose body mass index (BMI) remained constant or increased (group A) and by 61 percent in those who had lost weight (group B). Both BMI groups exhibited a trend toward shorter cycles with advancing age (Fig. 2). Hirsutism was more frequent in irregularly cycling women, although not significantly so. Cycle length could not be related to past treatment with clomiphene or gonadotropins to induce ovulation or to pregnancy. Of 144 women whose cycle length had changed, 95 percent claimed that their cycles had become shorter, and only 5 percent reported that cycles became longer as they became older. Fig. 1: Percentages of regular and irregular cycles in the various age groups. n is the number of patients in each age group. ▪ = regular, □ = irregular. © European Society of Human Reproduction and Embryology. Reproduced by permission of Oxford University Press/Human Reproduction.Fig. 2: Linear trends for regular cycles with age within the two BMI groups. Group A = P < .001, group B = P < .01. ▪ = group A: constant weight or weight gain; ▧ = group B: weight loss. © European Society of Human Reproduction and Embryology. Reproduced with permission of Oxford University Press/Human Reproduction.The menstrual cycle in women with PCOS seems to become regular as these women grow older. This may reflect a new balance between inhibin B and FSH in the polycystic ovaries as follicles are progressively lost. Hum Reprod 2000;15:24–28