Clinical, Reproductive, and Mental Health Features among Women with and Without Ultrasound-Confirmed Polyendocrine Metabolic Syndrome in Trinidad

Abstract

Polyendocrine Metabolic Ovarian Syndrome (PMOS) is the most common endocrine disorder in reproductive-aged women, affecting 10–13% globally, yet remains underdiagnosed in underrepresented regions. This study provides the first assessment of ultrasound-confirmed PMOS in Trinidad, examining the clinical, reproductive, dermatologic, and psychological profiles. In this cross-sectional study, women aged 18-45 years were recruited via social media and community outreach and completed a standardized electronic Clinical Report Form assessing reproductive history, androgenic features (modified Ferriman–Gallwey score, alopecia staging, acanthosis nigricans), and depressive symptoms (Beck Depression Inventory-II). Participants were classified as No PMOS, Probable PMOS, or Confirmed using the National Institutes of Health 1990, Rotterdam 2003, and the 2003 International PMOS Guidelines. Group differences were assessed using ANOVA/Kruskal–Wallis tests and multinomial logistic regression to estimate adjusted odds ratios (adjusted odds ratio, 95% CI). Of 301 women recruited, 43 (14%) had ultrasound-confirmed PMOS and 13 (4%) probable PMOS. Confirmed cases appeared younger (24.2 ± 5.8 vs. 29.8 ± 6.3 years; p = 0.006) but showed similar Body Mass Index (BMI) and lifestyle factors (alcohol, smoking and exercise) (p > 0.05). PMOS was associated with longer cycles (p = 0.009), fewer live births (p = 0.002), and greater use of oral contraceptives (OR 8.62, 95% CI 4.13–17.98; p < 0.001). Cutaneous featuresacne (OR 4.4), alopecia (OR 6.7), and acanthosis nigricans (OR 2.9) were significantly higher in PMOS groups. Depressive symptom severity increased with PMOS status (all p ≤ 0.001). This study provides the first community-based description of ultrasound-confirmed PMOS in Trinidad, showing a clear pattern of reproductive disruption, hyperandrogenic skin features, and a higher burden of depressive symptoms compared with women without PMOS. Although BMI and lifestyle behaviors were similar across groups, the strong links with contraceptive and metformin use suggest that many diagnosed women may already be engaging in clinical management. These preliminary findings from ultrasound-confirmed women with PMOS in Trinidad present clinical, reproductive, dermatologic, and psychological profiles broadly consistent with global patterns, though the modest confirmed-PMOS sample warrants replication in larger, multisite studies before generalization.