Prevalence of polycystic ovary syndrome (PCOS) and its associated hormonal and comorbid risk factors in Northeast India: a cross-sectional comparative study

Background: Polycystic ovary syndrome (PCOS) is a common endocrine disorder among women of childbearing age, affecting 8%-13% globally, associated with hyperandrogenism, anovulation, insulin resistance, cardiovascular diseases, and psychological issues, contributing to infertility and long-term health risks. Objective: To estimate the prevalence of PCOS and its association with infertility, hormonal disturbances, metabolic comorbidities, and lifestyle factors among reproductive-aged women in the Barak Valley region of Assam, Northeast India-an ethnically diverse and underserved area where genetic, lifestyle, and healthcare disparities may influence the prevalence and clinical presentation of PCOS. Design: Case-control study. Methods: A pre-validated questionnaire-based screening and multi-stage stratified random sampling method was applied among women aged 18-40 years based on Rotterdam criteria (2003) and NHMRC guidelines (2018). Clinical and biochemical hyperandrogenism, anthropometric, metabolic, hormonal, and ultrasonographic parameters were assessed. Results: = 53), with higher occurrence among native Bengali women. Phenotypes A, B, C, and D were identified at 39.62%, 20.75%, 7.54%, and 32.07%, respectively. Clinical hyperandrogenism manifested as acne (49.05%), hirsutism (43.39%), and alopecia (28.3%), while biochemical hyperandrogenism was observed in 92.45% based on elevated free testosterone levels. Menstrual issues involved oligomenorrhea (45.28%), amenorrhea (30.18%), and dysmenorrhea (33.96%). Metabolic abnormalities such as type II diabetes (52.83%), overweight (30.18%), obesity (9.43%), and obstructive sleep apnea (37.73%) were frequent. Elevated BMI, waist-hip ratio, luteinizing hormone (LH), anti-Müllerian hormone, and LH/FSH (follicle-stimulating hormone) ratio were observed. Free testosterone correlated strongly with clinical symptoms. Urban women reported poorer dietary habits (61.36%). Family history of PCOS and anxiety were commonly associated factors. Conclusion: PCOS in Barak Valley shows strong hormonal and metabolic abnormalities that may be influenced by lifestyle factors and underlying genetic predisposition. Early detection, targeted lifestyle changes, and regional awareness strategies are essential for improving reproductive and metabolic outcomes.