Objective To verify whether aging can modify the clinical and biochemical characteristics of women with polycystic ovary syndrome (PCOS). Material and methods This observational cross-sectional study was conducted at the reproductive endocrinology clinics of Julio Muller University Hospital and Tropical Institute of Reproductive Medicine in Cuiabá, MT, Brazil, between 2003 and 2017. Both, 796 PCOS and 444 non-PCOS normal cycling women underwent the same examination. PCOS was diagnosed using the Rotterdam criteria as recommended for adolescent and adult subjects. Anthropometric, metabolic, and endocrinological modifications with aging were initially examined in the two groups: control and PCOS. Further analyses were performed after a 5-year age stratification of data throughout the reproductive period. All participants signed a consent form approved by the local ethical committee. Results Biomarkers of adiposity were more remarkable in African descendant PCOS women. Body weight, waist/hip ratio, fat mass, and BMI were higher in PCOS women and tended to increase at all 5 age-strata, between ≤19 and 35 years of age. Serum androgen levels decreased with aging, markedly in PCOS subjects (P < 0.01 for all age-strata comparisons), but remained elevated when compared with the levels found in controls. Carbohydrate markers, triglycerides, and total cholesterol tended to increase over time in PCOS (P < 0.01 for all age-strata comparisons). Total cholesterol also tended to increase with age in non-PCOS women (P = 0.041). Conclusion The present study has shown that the advancing age influences many features of PCOS women. Biochemical hyperandrogenism, the core criterion recommended in the current systems to define the syndrome, showed statistically significant tendencies to decrease with aging progression but did not normalize. The use of age-adjusted features for the diagnosis of PCOS are recommended.

Aim To compare the corticosteroidogenic enzyme activities between normal cycling non‐polycystic ovary syndrome (PCOS), and normoandrogenic PCOS (NA‐PCOS) and hyperandrogenic PCOS (HA‐PCOS) patients. Methods This cohort study was conducted at Julio Muller University Hospital and Tropical Institute of Reproductive Medicine and Menopause, and enrolled 114 non‐PCOS women and 355 PCOS patients. The steroidogenic enzyme activities were measured using the serum steroid product/precursor molar ratio. Results In the Δ5 pathway the 17,20 lyase activity was equally low in the NA‐PCOS and HA‐PCOS women compared with the non‐PCOS women (P < 0.01 and P < 0.001, respectively). In the Δ4 pathway, the 17,20 lyase activity was higher only in the HA‐PCOS group (P < 0.001). The 17‐hydroxylase activity was the same in PCOS and non‐PCOS subjects (P > 0.05). The 3β‐hydroxysteroid dehydrogenase II (3β‐HSDII) activity was higher in the conversion of dehydroepiandrosterone into androstenedione in the HA‐PCOS than in the NA‐PCOS (P < 0.05) and the non‐PCOS patients (P < 0.01). The aromatase activity was lower in the HA‐PCOS than in the NA‐PCOS (P < 0.05) patients and non‐PCOS subjects (P < 0.01). In HA‐PCOS subjects, the 17,20 lyase activity was related to insulin, estradiol, total testosterone concentrations and free androgen index in the Δ5 pathway. 3β‐HSDII showed weak correlation with estradiol in the HA‐PCOS group. Anthropometric parameters had little impact, if any, on the steroidogenic enzyme activities. Conclusion The NA‐PCOS and HA‐PCOS patients demonstrated different enzyme activities, and the results provided new directions for future studies including PCOS patients with different phenotypes.

Measurement of hCG and/or its related molecules is useful in clinical practice, but greater awareness is needed worldwide regarding the use of new sensitive and specific assays tailored for different clinical applications.