Polycystic ovary syndrome, hyperprolactinemia, hyperinsulinemia and congenital adrenal hyperplasia
Objective: To research the frequencies of HPRL, HI and CAH in PCOS, as well deducing their significance.
Material and methods: For five years, 96 patients and their clinical histories were examined by the author, as each patient was visited.
HI was proven by 3 h OGGT, testing glucose and insulin simultaneously, ovarian ultrasonography, testosterone, androstenedione, DHEA, 17-hydoxyprogesterone, PRL and LH/FSH were also investigated.
The percentages and the confidence intervals (IC) were calculated with P<0.05.
Results: Percentages: HPRL in PCOS: 52.08% (50/96); CI=(0.3930.602). All cases with HI: 78.12% (75/96); CI=(0.67320.8502). All cases with CAH: 34.3575% (33/96); CI=(0.260.4596). Only HI: 29% (28/96); CI=(0.20420.3994). Only HPRL: 5.2% (5/96); CI=(0.01680.1178). Only CAH: 7.29% (7/96); CI=(0.03020.145). HPRL+HI+CAH: 16.66% (16/96); CI=(0.09840.2574). HPRL+HI: 26.04% (25/96); CI=(0.17660.361). HPRL+CAH: 4.166% (4/96); CI=(0.01140.1034). HI+CAH: 6.25% (6/96); CI=(0.02320.1316). None of these three: 5.2% (5/96); CI=(0.01680.1178).
Thus HPRL is very common in PCOS
These findings are basically coincidental with other authors. We can deduce PCOS may be the offspring of a complex aetiology: HI, CAH and HPRL, separately or jointly, all cause hyperandrogenemia by different pathways, although there is another group with none of these three causes. Recently, another cause: stress, was proven in rats; this was neutralized by cutting the ovarian nerves. Is this similar in human females?
Conclusion: PCOS is most frequently caused by HI, but other aetiologies are possible, among them CAH and HPRL. All three can be found together or separately; furthermore, stress may be another cause in some patients. Hyperprolactinemia is very common, appearing in around 52.08%, IC=39.360.2%.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.