Brief communication (Original). Hyperandrogenemia is associated with thin endometrium in reproductive-aged Thai women with polycystic ovary syndrome

Background: Pelvic ultrasonography is necessary for the diagnosis of polycystic ovary syndrome (PCOS). Compared with transabdominal ultrasonography, a transvaginal approach provides better endometrial imaging, but is more invasive. A thick endometrium is associated with endometrial abnormalities indicating further surveillance.

Objectives: We determined factors associating with endometrial thickness in PCOS Thai women. The information is useful to identify patients who need endometrial surveillance.

Methods: One hundred sixty-nine Thai women with PCOS diagnosed using revised Rotterdam 2003 criteria were examined for weight, height, waist circumference, and signs of hyperandrogenism. Endometrial thickness was determined by ultrasonography. Venous blood samples were collected after 12-hour fasting period and at 2 hours after 75-gram oral glucose loading.

Results: Endometrial thickness had moderate correlation with BMI (r = 0.207, p = 0.007), 2-hour glucose (r = 0.227, p = 0.003), and serum total testosterone (r = -0.278, p < 0.001); it had weak to null correlation (r < 0.2) with age, duration of amenorrhea, waist circumference, Ferriman-Gallwey score, and other parameters of insulin resistance and hyperandrogenemia. Multiple logistic regression analysis demonstrated that important factors associating with endometrial thickness ≥7 mm were total testosterone >0.8 ng/mL (OR = 0.241, 95%CI 0.118-0.493, p < 0.001) and BMI >23.5 kg/m² (OR = 2.431, 95%CI.1.196-4.939, p = 0.014).

Conclusions: Endometrial thickness in PCOS Thai women has significantly inverse correlation with serum total testosterone and positive correlation with BMI. Endometrial thickness measurement using transvaginal ultrasonography may be unnecessary for PCOS Thai women with hyperandrogenism.