Proposed criteria for the identification of polycystic ovary syndrome following menopause: An ancillary study of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

Objectives: To propose plausible criteria with which to identify menopausal women with PCOS.

Study Design: A cross-sectional study involving the baseline data of 713 menopausal women at admission to the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) in Salvador, Bahia, Brazil.

Main Outcome Measures: PCOS was identified by the presence of two of three criteria. (1) A history of amenorrhea or oligomenorrhea (OL) (regular intermenstrual intervals ≥35 days during reproductive life); (2) clinical or biochemical hyperandrogenism (HA), identified by a score ≥5 points in a hirsutism questionnaire constructed and validated for women in this age group, or total or free testosterone ≥ the 95th percentile for women considered normal; (3) insulin resistance (IR) (a homeostatic model assessment [HOMA] index≥2.2). Validation was performed using probable epidemiological endpoints.

Results: According to these criteria, 7.6% of the women in the sample had PCOS. Of these, 7.4% had HA and OL, 72.2% had HA and IR, 14.8% had OL and IR and 5.6%, had HA, OL and IR. Women with PCOS were younger, had had fewer pregnancies and entered menopause earlier. Positive associations were found between PCOS and overweight (PR: 1.31; 95%CI: 1.18-1.46), obesity (1.44; 1.01-2.06), carbohydrate metabolism disorders (impaired glucose tolerance and diabetes mellitus) (1.30; 1.03-1.65), and with diabetes alone (1.41; 0.83-2.39), although this latter association failed to reach statistical significance.

Conclusion: The women selected in accordance with these criteria had the characteristics of PCOS that are not only expected, but also widely associated with this disorder.