Affiliation:
1. Clinical Division of Gynecological Endocrinology and Reproductive Medicine, Department of Obstetrics and Gynecology Medical University of Vienna Vienna Austria
2. Department of Laboratory Medicine Medical University of Vienna Vienna Austria
3. Faculty of Medicine Henri Warembourg University of Lille Lille Cedex France
Abstract
AbstractPurposeTo study how many women are misdiagnosed with polycystic ovary syndrome (PCOS) instead of functional hypothalamic amenorrhea (FHA), which is important to improve overall well‐being, long‐term health, and fertility issues.MethodsThe FHA prevalence in a cohort of 401 women previously diagnosed with PCOS (revised Rotterdam criteria) was estimated retrospectively based on experts and previous studies: luteinizing hormone (LH) <2 IU/mL, LH <5.36 IU/mL, sex hormone binding globulin (SHBG) >53.3 nmol/L, Testosterone <0.36 ng/mL, and the formula of Beitl et al. [(7.05*testosterone ng/mL) − (0.005*SHBG nmol/L) + (0.117*LH mIU/mL) − 2.463 < 0].ResultsThe highest rate of women with suspicion of FHA in patients referred for PCOS was found when the SHBG cut‐off of ≥53.3 nmol/L was used (36.9%), followed by the use of the LH cut‐off of <5.36 IU/mL (12.5%). The minimal suspected rate was achieved with the LH cut‐off <2.0 IU/mL (1.7%). Women who fulfilled the criteria for PCOS phenotype D (ovulatory dysfunction and polycystic ovarian morphology) revealed the maximum rate for suspected FHA (up to 47.6%).ConclusionIt is still necessary to evaluate reliable markers for the differential diagnosis between PCOS and FHA to avoid incorrect treatment, which might lead to negative long‐term effects in women with undiagnosed FHA.