Abstract
Context
Premature adrenarche (PA) may increase the risk for polycystic ovary syndrome (PCOS).
Objective
To study features of PCOS in young adult women with a history of PA.
Design and participants
Thirty PA and forty-two control females were followed from prepuberty to young adulthood (median age 18.1 years).
Main outcome measures
Ovarian function, the use of contraceptives, and clinical and biochemical indicators of hyperandrogenism.
Results
We found no differences in the use of hormonal contraceptives (50 vs 50%, PA vs controls, respectively; P > .999), indication for using contraceptives (P = .193), or in the history of oligo- (17 vs 26%, P = .392) and amenorrhea (0 vs 0%, P > .999). Among women not using hormonal contraceptives, those with a history of PA had a higher prevalence of hirsutism (27 vs 0%, P = .023) but not acne (87 vs 67%, P = .252). Steroid profiles were broadly comparable between the groups, but PA women had lower sex hormone-binding globulin (SHBG) concentrations (30.1 vs 62.4 nmol/l, P < .001) resulting in higher free androgen index (3.94 vs 2.14, P < .001). The difference in SHBG levels persisted through BMI adjustment. SHBG correlated negatively with HOMA-IR (r -0.498, P = .003). Anti-Mullerian hormone concentrations were comparable between the groups (39.3 vs. 32.1 pmol/l, P = .619).
Conclusions
PA was not associated with evident ovarian dysfunction in young adult women. However, women with a history of PA had decreased SHBG levels and thus, increased bioavailability of circulating androgens.
Heightened risk of pain in young adult women with a history of childhood maltreatment
