Association between Insulin Resistance and Abnormal Menstrual Cycle in Females with Polycystic Ovary Syndrome

Abstract

Aim: To determine the association between insulin resistance and abnormal menstrual cycle in females with polycystic ovary syndrome.

Materials and methods: The prospective observational study was conducted in the Department of Gynaecology and Obstetrics. Total 100 females had complaints of abnormal menstruation, acne, hirsutism, and problems with fertility, and 100 controls having long-standing history of normal menstrual cycles, were enrolled for the study. Demographic, menstrual, clinical, and family history data were collected using a structured questionnaire. Anthropometric measurements and transvaginal ultrasonography were performed. Fasting blood samples were analyzed for glucose, lipid profile, insulin, FSH, LH, and testosterone using standard methods. HOMA-IR >2.5 was considered indicative of insulin resistance.

Results: The mean age was comparable between groups (p = 0.455), while BMI and WHR were significantly higher in women with PCOS. PCOS women also had significantly higher fasting glucose, insulin, HOMA-IR, total cholesterol, LDL, triglycerides, LH/FSH ratio, and testosterone levels than controls. Among PCOS subgroups, fasting insulin, HOMA-IR, LH/FSH ratio, and testosterone increased significantly with longer menstrual cycle intervals (p < 0.05), indicating greater insulin resistance and hyperandrogenism with increasing menstrual irregularity.

Conclusion: Oligomenorrhea (>45-day cycles) was common in women with PCOS, with increasing menstrual irregularity associated with greater hyperandrogenism and insulin resistance. Menstrual cycle length may serve as a simple clinical predictor of insulin resistance in PCOS.