Prevalence of hyperandrogenic states in late adolescent and young women: epidemiological survey on Italian high-school students

Context. Most of the estimates of the prevalence of hyperandrogenic states refer to the general adult population. Objective. To estimate the prevalence of hyperandrogenic states in late adolescence and youth and to evaluate potential independent predictors. Design. Cross-sectional study Setting. High schools Patients. Female students, aged 16-19y Main Outcome Measures. The study protocol was designed with three possible levels of participation: the first level consisted of a self-compiled questionnaire; the second level added a medical examination; the third level added a blood sample for laboratory testing. LC-MS/MS was used to measure total testosterone and a reference interval was established in-house. Results. We offered participation to 2052 students. 1469 compiled the questionnaire. Of them, 1038 were examined, and 519 also provided blood samples. 203 of the 1038 examined students and 125 of the 519 students who provided blood samples were subsequently excluded because of treatment with oral contraceptives or because of endocrine disorders. In the sample of women with questionnaire + medical examination, 13% were affected by isolated menstrual irregularity, 16.1% by isolated clinical hyperandrogenism and 3.8% by both states. A similar prevalence of isolated menstrual irregularity (10.2%) and of isolated clinical hyperandrogenism (16.7%) was found in the sub-sample of women with laboratory tests; in addition, 6.6% showed isolated hyperandrogenemia, and 4.3% proved to be affected by PCOS. Conclusions. This study provides for the first time a reliable assessment of the prevalence of hyperandrogenic states in late adolescent and young females and confirms that hyperandrogenic disorders originate during young age