Polycystic ovarian syndrome (PCOS) is the most prevalent female endocrine disorder affecting between 5-15% of women. Characterized by a combination of polycystic ovaries, androgen excess, and abnormal ovulation, untreated PCOS may progress to metabolic abnormalities and increase the risk of adverse health outcomes. Adult PCOS is evaluated using the Rotterdam Consensus Criteria, which requires two of three clinical findings. PCOS is a condition of exclusion, and it is essential to consider differential pathologies before diagnosis. PCOS is a heterogeneous condition, and treatment is fitted to the symptoms that each individual experiences. The physiological effects of PCOS present during puberty, typically around the average age of menarche. The exact etiology of PCOS is unknown, and preventing and curing the condition is not yet possible. Metabolic disturbances caused by PCOS, including insulin resistance and increased blood glucose level, are treated with similar methods as diabetes type 2. Insulin sensitizing agents are used to treat insulin resistance caused by PCOS. The primary treatment for insulin resistance in this population is metformin (Glucophage) due to its relatively safe use and effectiveness in normalizing insulin sensitivity and assisting with normalizing weight. The correlation of PCOS with insulin resistance, central obesity, and metabolic syndrome highlights the importance of diet and exercise supplementation for this population. Weight loss of only 5% in obese and overweight PCOS patients can significantly improve PCOS symptoms, including insulin resistance, androgen levels, and fertility. Exercise alone helps increase the sensitivity of skeletal muscle to insulin and decreases metabolic syndrome risk. The effect of PCOS on the hypothalamic-pituitary-gonadal axis can be detrimental to ovulation and implantation of a fertilized egg. Treatments that suppress the HPG-axis cannot be continued during attempts to become pregnant and throughout pregnancy. Ovulation-inducing agents can improve the rate of ovulation and increase fertility; however, some women may become resistant to these treatments. Clomiphene citrate (Clomid) is often the primary drug used to induce ovulation; however, monotherapy with letrozole has shown greater improvements in pregnancy and live birth rates. Gonadotropins may also be successful treatments, but there is an accompanied increased risk of ovarian hypersensitivity syndrome and multiple pregnancies. Laparoscopic ovarian drilling may help decrease androgen production in the ovary and briefly increase pregnancy capability. During pregnancy, metformin may help decrease the risk of gestational diabetes; however, the long-term effect of fetal exposure to metformin is not well studied. Cosmetic symptoms of PCOS, including hirsutism and acne vulgaris, may cause severe social stress. PCOS women are at additional risk of depression and anxiety. Cosmetic and mental health concerns, combined with the stress caused by the high prevalence of infertility in PCOS, highlight the need for psychological help to be considered in improving the overall quality of life. Combining cognitive behavioral therapy with treatments may help PCOS women maintain treatment and improve their quality of life. The most effective treatment may require modification throughout a patient’s life due to the variance in gonadocorticoid levels throughout a female’s life. Post-menopausal women continue to have excess androgens and estrogens in circulation. High levels of ovarian and adrenal production of gonadocorticoids combined with decreased circulating binding globulins can lead to stress on the metabolic and cardiovascular systems in PCOS after menopause. Continuous levels of increased triglycerides increase the risk for atherosclerosis and adverse cardiac events. PCOS women have an increased risk of endometrial and ovarian cancer, while a link between breast cancer and PCOS is widely disputed. There is 1.66 times higher risk for cardiovascular events, including 1.96 times greater risk for stroke in women with PCOS compared to non-PCOS women when controlled for weight. As we begin to understand the increased risk factors for hypertension, hyperlipidemia, and cardiovascular stress with PCOS, it is crucial to understand how to diagnose and treat PCOS patients in the early stages of the disorder. Irregularities in typical puberty and menarche in adolescents increase the difficulty of diagnosis and may delay a diagnosis.

Class of 2006 Abstract / Objectives: To determine if Polycystic Ovarian Syndrome (PCOS) patients treated with lifestyle changes and metformin resulted in ovulation after six months of treatment. Methods: A retrospective chart review of initial patient visits at an infertility clinic were obtained. Patients that were given a diagnosis of PCOS were further reviewed for age at initial diagnosis, weight, height, ovarian cysts, lifestyle recommendations (diet, exercise, and vitamin use), metformin recommendations and usage, and if ovulation occurred after six months of treatment. Results: A total of 1011 charts were reviewed. At the initial office visit, 206 (20.38%) of these patients were classified as having PCOS. Of PCOS patients, 113 (54.85%) patients ovulated after six months of treatment. In the average initial weight, ovulators averaged slightly less weight than did non-ovulators (171.77 pounds ± 44.26 vs. 188.65 pounds ± 51.37, p=0.0121). This also follows true for the initial BMI of ovulators vs. non-ovulators (29.53 kg/m2 ± 10.14 vs. 32.69 kg/m2 ± 13.03, p=0.0521). There was a significant difference in metformin use between ovulators and non-ovulators (90.27% vs. 73.12%, p=0.0024). More ovulators were found to continue metformin treatment as compared to non-ovulators. Conclusions: In this specific infertility clinic setting, 20.3% of patients were diagnosed with PCOS at the initial office visit. Of these PCOS patients, treatment with lifestyle changes and metformin use resulted in 55% of patients achieving ovulation at six months. This study shows that weight loss, through lifestyle modification and metformin treatment, increases this population’s chances of ovulation within six months of therapy.

BACKGROUND. Polycystic ovarian syndrome is one of the commonest endocrinopathies in women of reproductive age. The prevalence of the disease is estimated to be around 5 % in general population (Azziz, 2004). Literature on the prevalence of PCOS in Black women is limited (Knochenhauer, 1998). This syndrome is a diagnostic conundrum due to the phenotypic variability of these women. The PCOS woman also has a greater disposition for impaired glucose homeostasis as well as hyperlipidaemia. OBJECTIVE. The hormonal and metabolic profiles of South African women with PCOS have not been described. Ethnic differences in the prevalence of PCOS have also not been well explored. Our study aims to describe and compare the phenotypic profile of African and Indian women with PCOS and to determine the frequency of insulin resistance and hyperlipidaemia in these women. METHODS. A retrospective audit of all patients attending gynaecology endocrine and infertility clinics over the period June 2005 to June 2009 was carried out. The biochemical and clinical profiles were analysed and a comparative analysis between the two largest groups, Indian and Black women were done. All women that attended these clinics were subjected to a fasting lipogram and fasting serum glucose. An abnormal fasting serum glucose would have necessitated a full glucose tolerance test. RESULTS. A total of 110 patients were analysed in this study. There were 87 Indian patients, 16 Black patients, 5 Coloured patients and 2 White patients. Eighty nine percent of PCOS women studied had an increased body mass index (>25). There was an increased LH:FSH in 66 (75.9%) of Indian women and 13 (81.3%) of Black women. Increased androgens were present in 26 (30.2%) in Indian women and 6 (37.5%) of Black women. An increase in fasting insulin was found in 48 (55.2%) of the Indian women and 5 (31.3%) of the Black women. Twenty five (29.1%) Indian women had an increase in fasting serum glucose compared to 1 (6.3%) in Black women. In the Indian population, 13 (14.9%) were found to have Diabetes Mellitus, and 9 (10.3%) had an impaired glucose tolerance test. In the Black population only 1 patient had impaired glucose tolerance. There were no Black patients with Diabetes Mellitus. No Black women were found to have hyperlipidaemia, however 12 (14.3%) Indian women were affected. None of these differences between the races were statistically significant. The major limitation of the study was the sample size of Black women. This is an ongoing study, and aims to recruit more Black women. This will be able to adequately address the correct perspective regarding the metabolic and cardiovascular abnormalities in these women. CONCLUSION. The prevalence of insulin resistance and hyperlipidaemia in local women with PCOS was 50.9%.and 11.3% respectively. Menstrual irregularities and infertility are the most frequent presenting complaints of women with PCOS. Features of hyperandrogenism are not common presenting complaints in South African women. There are no differences in the hormonal and clinical profile of South African Indian and Black women with PCOS, however, there is a trend toward Indian women having a greater prevalence of glucose abnormalities than Black women. We recommend further studies in the management of the metabolic abnormalities in local women with PCOS, in an attempt to develop a protocol to manage the metabolic complexities of PCOS. / Thesis (M.Med)-University of KwaZulu-Natal, Durban, 2010.

Follicular growth and maturation are tightly regulated processes, which involve the participation of endocrine, autocrineparacrine factors and intracellular molecules. Due to the numerous research efforts, a large number of regulators and their mechanisms of regulation of follicular growth and differentiation have been established. Although the abnormal expression and activities of some of these regulators are believed to be associated with ovarian dysfunction diseases, such as polycystic ovarian syndrome (PCOS), the etiology and pathogenesis of this syndrome are not completely understood. In this thesis, we have identified two novel regulators of follicular growth and differentiation and examined the cellular and molecular mechanisms that contribute to the folliculogenesis. We present here that chemerin reduces FSH-induced steroidogenic enzyme expression and steroid hormone production in follicles and granulosa cells. Prohibitin expression is upregulated by chemerin and knockdown of prohibitin attenuates the suppressive role of chemerin on steroidogenesis, an action regulated by Akt. Using an androgenized rodent model, we also present the dysregulation of chemerin and prohibitin and their association with dysregulated follicular steroidogenesis. Our data and preliminary clinical studies demonstrate the potential involvement of chemerin and prohibitin in the etiology of PCOS. These studies significantly improve the knowledge of ovarian functions and the pathophysiology of PCOS, and provide important clues for the development of novel diagnosis biomarkers and new treatment strategies for this complex syndrome.

Follicular growth and maturation are tightly regulated processes, which involve the participation of endocrine, autocrineparacrine factors and intracellular molecules. Due to the numerous research efforts, a large number of regulators and their mechanisms of regulation of follicular growth and differentiation have been established. Although the abnormal expression and activities of some of these regulators are believed to be associated with ovarian dysfunction diseases, such as polycystic ovarian syndrome (PCOS), the etiology and pathogenesis of this syndrome are not completely understood. In this thesis, we have identified two novel regulators of follicular growth and differentiation and examined the cellular and molecular mechanisms that contribute to the folliculogenesis. We present here that chemerin reduces FSH-induced steroidogenic enzyme expression and steroid hormone production in follicles and granulosa cells. Prohibitin expression is upregulated by chemerin and knockdown of prohibitin attenuates the suppressive role of chemerin on steroidogenesis, an action regulated by Akt. Using an androgenized rodent model, we also present the dysregulation of chemerin and prohibitin and their association with dysregulated follicular steroidogenesis. Our data and preliminary clinical studies demonstrate the potential involvement of chemerin and prohibitin in the etiology of PCOS. These studies significantly improve the knowledge of ovarian functions and the pathophysiology of PCOS, and provide important clues for the development of novel diagnosis biomarkers and new treatment strategies for this complex syndrome.

Female sheep exposed to excess testosterone (T) in utero display symptoms similar to those observed in women with polycystic ovarian syndrome (PCOS). Prenatal T-treated ewes display masculinized sexual behavior and increased food-reward seeking behavior. A neural substrate critical for these goal-directed behaviors is the dopaminergic system in the ventral tegmental area. We have recently shown that in adult ewes dopamine expression in the VTA is increased by prenatal T exposure. In this thesis, I tested the hypothesis that alterations of the VTA dopamine system by prenatal-T are caused via activation of androgen (AR) and/or insulin receptors (IR). Analysis of immunohistochemical staining shows an increase of tyrosine hydroxylase (TH) expression, AR, or IR, along with changes in co-expression of AR/TH and IR/TH. These changes were blocked or reversed by prenatal treatments with flutamide or rosiglitazone, or postnatal treatments with rosiglitazone or metformin, implicating AR and IR in alterations of the VTA

BACKGROUND: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine dysfunction problems among women of the reproductive age, with a global prevalence of 4-20%, causing 430,000 associated DALYs. Initial treatment of PCOS is mainly focused on diet and exercise and, if left untreated, PCOS can lead to many complications including, but not limited to, diabetes, metabolic syndrome, cardiovascular disease and endometrial cancer. In India, one out of five women are found to have PCOS with the numbers increasing with every year, according to a 2015 study done by Metropolis Healthcare. Some studies done in other parts of the country have shown that there is very limited knowledge about PCOS. Currently there is no data about the knowledge, attitudes and practices about PCOS in Kerala, India, which is an area known to have the highest rates of diabetes in India as well as an area having a high rate of infertility. PROPOSED PROJECT AND SIGNIFICANCE: This study is proposed to assess the knowledge, attitudes and practices of PCOS among women of reproductive age (18-45 years) in urban and rural areas of Thrissur, Kerala, India. This will help in understanding if there are any barriers to treatment and highlight the best preventive measures, as well as treatment strategies in this population, that might reduce its health burden. CONCLUSION: This will be a pilot study assessing perceptions of PCOS in Kerala, India. If this study demonstrates a low understanding of PCOS as shown in other parts of India, this will provide help in understanding the reasons why the prevalences of PCOS as well as diabetes and infertility, are increasing in the state of Kerala.

A Síndrome dos Ovários Policísticos (SOP) afeta uma grande parcela da população feminina em idade reprodutiva. Além das alterações morfológicas, hormonais e metabólicas, essas mulheres também apresentam uma alta prevalência de obesidade e alterações no controle autonômico cardiovascular de acordo com a literatura, principalmente modificações na modulação autonômica da variabilidade da frequência cardíaca (VFC). No entanto, pouco sabemos sobre outros parâmetros do controle autonômico, como a variabilidade da pressão arterial (VPA) e a sensibilidade barorreflexa (SBR). Portanto, o principal objetivo do estudo foi investigar em mulheres com a SOP as alterações na modulação autonômica da VPA e na SBR, bem como avaliar se essas alterações são decorrentes da SOP ou do aumento da gordura corporal. Para tanto, foram estudadas 30 mulheres voluntárias eutróficas (IMC ? 25 kg/m2) sem a SOP e 60 mulheres voluntárias com a SOP divididas em dois grupos: eutróficas (IMC ? 25 kg/m2; N=30) e obesas (IMC ? 30 kg/m2; N=30). Todas as mulheres foram submetidas aos seguintes protocolos; coleta de sangue para hemograma completo; avaliação antropométrica e avaliação de parâmetros metabólicos e hormonais em repouso; registro de parâmetros hemodinâmicos e cardiorrespiratórios em repouso e durante o exercício físico; análise da VFC e da VPA; e análise da SBR espontânea. A comparação entre os grupos eutróficos com e sem SOP não apresentou qualquer diferença nos parâmetros autonômicos avaliados. No entanto, a comparação entre os grupos SOP mostrou que o grupo SOP obeso apresentou menores valores de VO2 e testosterona, e maiores valores de triglicerídeos e da pressão arterial em relação ao grupo SOP eutrófico. Quanto aos parâmetros autonômicos, os grupos obeso e eutrófico não diferiram na análise da VPA. Entretanto, o grupo SOP obeso apresentou menores valores da SBR espontânea e das oscilações de baixa frequência (LF) da VFC em unidades absolutas. Por fim, nossos resultados sugerem que a obesidade pouco alterou a VFC em mulheres com SOP, entretanto reduziu sensivelmente a SBR espontânea. Esses achados podem estar associados com diferenças hormonais encontradas nessas mulheres, como os níveis séricos de testosterona mais elevados no grupo eutrófico. / Polycystic Ovarian Syndrome (PCOS) affects a large proportion of the female population at reproductive age. In addition to morphological, hormonal and metabolic alterations, these women also present a high prevalence of obesity and alterations in cardiovascular autonomic control according to the literature. Mainly modifications in the autonomic modulation of heart rate variability (HRV). However, we do not know much about other parameters of autonomic control, such as blood pressure variability (APV) and baroreflex sensitivity (SBR). Therefore, the main objective of the study was to investigate in women with PCOS changes in the autonomic modulation of APV and SBR, as well as to assess whether these alterations are due to PCOS or increased body fat. In order to do, 30 eutrophic non-PCOS voluntary women (BMI ? 25 kg / m2) and 60 voluntary PCOS women who were studied in two groups: PCOS eutrophic (BMI ? 25 kg / m2, N = 30) and PCOS obese women (BMI ? 30 kg / m2, N = 30). All the women were submitted to the following protocols; collection of blood for complete blood count; anthropometric evaluation and evaluation of metabolic and hormonal parameters at rest; recording of hemodynamic and cardiorespiratory parameters at rest and during physical exercise; analysis of HRV, APV and spontaneous SBR analysis. The comparison between the eutrophic PCOS and nonPCOS groups showed no difference in the autonomic parameters evaluated. However, the comparison between the PCOS groups showed that the PCOS obese group presented lower values of VO2 and testosterone, and higher triglyceride values and blood pressure in relation to the PCOS eutrophic group. Regarding the autonomic parameters, the PCOS obese and eutrophic groups did not differ in the APV analysis. However, the PCOS obese group presented lower values of spontaneous SBR and low frequency oscillations (LF) of HRV in absolute units. Finally, our results suggest that obesity did not significantly alter HRV in women with PCOS, but it significantly reduced spontaneous SBR. These findings may be associated with hormonal differences found in these women, such as higher serum testosterone levels in the PCOS eutrophic group.

Chronic diseases such as systemic arterial hypertension, type 2 diabetes mellitus, osteoporosis and polycystic ovarian syndrome are prevalent in Brazil and are responsible not only for considerable morbidity and mortality in specific segments of the population, but also for high financial costs. Despite all their relevance, the diagnosis of these health problems in our country is not performed in an ideal way. As a consequence, there is a difficulty to act preventively in these pathologies, generating unwanted clinical complications. The difficulty of establishing diagnoses uniformly in common pathologies is not unique to our country. There are studies that demonstrate that the recognition of polycystic ovary syndrome is under-registered in developed countries such as Australia, as well as osteoporosis in China. At these sites, a variation in the identification of these pathologies has been demonstrated according to the physician's specialty. The objective of this study was to evaluate, through a questionnaire, the awareness regarding the diagnosis and management of polycystic ovarian syndrome and osteoporosis among the specialized physicians whom works in these areas (gynecologists and endocrinologists) in the city of Santa Maria, southern Brazil, where has a population of about 300,000 inhabitants. To improve this comparison, two other prevalent diseases (type 2 diabetes mellitus and systemic arterial hypertension) were included in the same questionnaire. A crosssectional study was carried out between July and August 2015 (Approval of CAAE 43401415.3.0000.5346). In total, 90% of endocrinologists and 75% of gynecologists out of a total of 97 physicians registered in the Regional Council of Medicine completed the questionnaire that was applied by a trained interviewer. No differences related to age, gender and time of work experience were observed among these specialists. In general, the responses of endocrinologists and gynecologists were consistent. Considering the questions about polycystic ovarian syndrome, the decision to include total testosterone, 17OHP, and prolactin was significantly higher in the group of endocrinologists than gynecologists. Regarding osteoporosis, the inclusion of the history of low-impact fractures in the diagnosis of osteoporosis was significantly more reported by gynecologists than endocrinologists. As expected, sequential identification of secondary causes of osteoporosis was more frequently performed by endocrinologists than gynecologists, who also identified a greater number of drug treatment options. To our knowledge, this is the first initiative to estimate differences in the recognition of polycystic ovarian syndrome and osteoporosis among gynecologists and endocrinologists using a medium-sized Brazilian city. It is believed that the information coming from this study will enable in the future the development of strategies and production of technical support materials directed to an improvement in the quality of the health care service. / Doenças crônicas como hipertensão arterial sistêmica, diabetes mellitus tipo 2, osteoporose e síndrome dos ovários policísticos são prevalentes no Brasil e se tornam responsáveis não somente por considerável morbi-mortalidade em segmentos específicos da população, mas também por elevados custos financeiros. Apesar de toda a sua relevância, o diagnóstico destes problemas de saúde em nosso meio não é realizado de uma maneira ideal. Como consequência, existe uma dificuldade para atuar preventivamente nestas patologias, gerando complicações clínicas indesejadas. A dificuldade para estabelecer diagnósticos de uma maneira uniforme em patologias comuns não é exclusiva do nosso país. Existem estudos que demonstram que o reconhecimento da síndrome dos ovários policísticos é subregistrado em países desenvolvidos como a Austrália, assim como a osteoporose na China. Nesses locais, demonstrou-se uma variação na identificação destas patologias de acordo com a especialidade do médico. O presente estudo teve como objetivo avaliar através de questionário o conhecimento relativo ao diagnóstico e manejo pontual da síndrome dos ovários policísticos e osteoporose entre os médicos especialistas que mais atuam nestas áreas (ginecologistas e endocrinologistas) no município de Santa Maria, sul do Brasil, que tem uma população de cerca de 300.000 habitantes. Para melhor comparação, outras duas doenças prevalentes (diabetes mellitus tipo 2 e hipertensão arterial sistêmica) foram incluídas no mesmo questionário. Foi realizado um estudo transversal entre os meses de julho e agosto de 2015 (Aprovação do CAAE 43401415.3.0000.5346). Ao todo, 90% dos endocrinologistas e 75% dos ginecologistas de um total de 97 médicos registrados no Conselho Regional de Medicina completaram o questionário que foi aplicado por um entrevistador treinado. Nenhuma diferença relacionada à idade, gênero, tempo de experiência de trabalho foram observadas entre estes especialistas. De maneira geral, as respostas de endocrinologistas e ginecologistas foram similares. Considerando as questões sobre síndrome dos ovários policísticos, a decisão de incluir testosterona total, 17OHP, e prolactina foi significativamente maior no grupo de endocrinologistas que ginecologistas. Em relação à osteoporose, a inclusão da história de fraturas de baixo impacto no diagnóstico de osteoporose foi significativamente mais referida por ginecologistas que endocrinologistas. Como esperado, a identificação sequencial de causas secundárias de osteoporose foi mais frequentemente realizada por endocrinologistas que ginecologistas, que também identificaram um maior número de opções de tratamento medicamentoso. Consideramos que esta seja a primeira iniciativa de estimar as diferenças de reconhecimento de síndrome dos ovários policísticos e osteoporose entre ginecologistas e endocrinologistas utilizando uma cidade brasileira de tamanho médio. Acredita-se que as informações advindas deste estudo possibilitarão no futuro o desenvolvimento de estratégias e produção de materiais técnicos de apoio direcionados a uma melhoria na qualidade do serviço assistencial de saúde.

Polycystic Ovarian Syndrome (PCOS) is the most frequent metabolic disorder in the female population. It affects 10% of women of childbearing age, and its pathophysiology, although not completely known, is associated with insulin resistance, hyperandrogenism and gonadotropin alteration. The diagnosis is of exclusion and is difficult due to the multiple phenotypes found, being fundamental the presence of menstrual dysfunction and alteration of the levels of androgens. Hirsutism, increased pilification in androgen-dependent areas, is a frequent complaint and correlates with PCOS in up to 95% of cases. Women with PCOS are at greater risk for developing metabolic syndrome and cardiovascular disease. These comorbidities usually manifest with aging and there are no guidelines for diagnosing PCOS after menopause. Because of this, we have attempted to prove the hypothesis that the history of self-reported hirsutism and / or oligomenorrhea influences the calculation of risk for comorbidities after menopause (type 2 diabetes mellitus, asthma, chronic bronchitis or emphysema, osteoarthritis, stroke, Heart failure, angina or myocardial infarction, multiple sclerosis, neoplasia, and Parkinson's disease). This cross-sectional study investigated women (1057) with at least 55 years of age, post-menopausal, with no cognitive deficit and / or communication difficulty who were seen in primary care services in a municipality in the south of Brazil during the 24-month period, Through a structured questionnaire that collected self-reported data on the presence of comorbidities, reproductive history and complaint of hirsutism in menacme. A significantly higher prevalence of comorbidities was found in women with a history of hirsutism and / or oligomenorrhea [OR = 1.6 (95% CI 1.1-2.4), or = hirsutism [OR 2.0 95% CI 1.3-3.2), P = 0.004]. As well as the prevalence of stroke, angina or myocardial infarction, heart failure, chronic obstructive pulmonary disease and osteoarthritis were significantly higher (p <0.03). Therefore, the presence of hirsutism and oligomenorrhea in menacing are risk factors for comorbidities, mainly cardiovascular, these alterations are possibly associated with the presence of PCOS, so its correct diagnosis in the menacme could avoid the reduction of quality of life in senectude. / Síndrome dos Ovários Policísticos (SOP) é a desordem metabólica mais frequente na população feminina, acomete 10% das mulheres em idade fértil e cuja fisiopatologia, apesar de não ser completamente conhecida, associa-se a resistência à insulina, hiperandrogenismo e alteração das gonadotropinas. O diagnóstico é de exclusão e dificultado devido aos múltiplos fenótipos encontrados, sendo fundamental a presença de disfunção menstrual e alteração dos níveis de androgênios. O hirsutismo, pilificação aumentada em áreas andrógeno-dependentes, é queixa frequente e correlaciona-se a SOP em até 95% dos casos. Mulheres portadoras de SOP tem maior risco para desenvolver síndrome metabólica e doenças cardiovasculares. Essas comorbidades costumam manifestar-se com o envelhecimento e inexistem diretrizes para diagnosticar SOP após a menopausa. Devido a isso, tentamos comprovar a hipótese de que a história de hirsutismo e/ou oligomenorreia autorrelatada na menacme influencia no cálculo do risco para comorbidades após a menopausa (diabetes mellitus tipo 2, asma, bronquite crônica ou enfisema, osteoartrite, acidente vascular cerebral, insuficiência cardíaca, angina ou infarto do miocárdio, esclerose múltipla, neoplasia e doença de Parkinson). Esse estudo transversal investigou mulheres (1057) com pelo menos 55 anos, na pós-menopausa, sem déficit cognitivo e/ou dificuldade de comunicação que foram atendidas em serviços de atenção primária de um município do sul de Brasil durante o período de 24 meses, através de um questionário estruturado que coletou dados autorrelatados da presença de comorbidades, história reprodutiva e queixa de hirsutismo na menacme. Identificou-se prevalência de comorbidades significativamente maior nas mulheres com história de hirsutismo e/ou oligomenorreia [OR = 1,6 (95% IC 1,1-2,4), p = 0,002] ou hirsutismo isolado [OR 2,0 (IC 95% 1,3-3,2), P = 0,004]. Assim como a prevalência de acidente vascular cerebral, angina ou infarto do miocárdio, insuficiência cardíaca, doença pulmonar obstrutiva crônica e osteoartrite foram significativamente maiores (p <0,03). Portanto, a presença de hirsutismo e oligomenorreia na menacme são fatores de risco para comorbidades, principalmente cardiovasculares, essas alterações são possivelmente associadas a presença de SOP, por isso seu correto diagnóstico na menacme poderia evitar a redução da qualidade de vida na senectude.