Polycystic Ovary Syndrome and Metabolic Abnormalities Among Women Presenting with Moderate-to-Severe Acne

Open Access

Abstract

Introduction: Polycystic ovary syndrome (PCOS) is a common endocrine disorder in reproductive-aged women and is frequently associated with hyperandrogenism, menstrual dysfunction, insulin resistance, and metabolic abnormalities. Acne, particularly when moderate to severe or persistent, may be an important cutaneous manifestation of androgen excess and can provide an opportunity to identify underlying PCOS. This study aimed to assess polycystic ovary syndrome and metabolic abnormalities among women presenting with moderate-to-severe acne. Methods & Materials: A cross-sectional analytical study was conducted in the Department of Dermatology, MH Samorita Hospital & Medical College, Dhaka, Bangladesh, from January 2025 to December 2025, among 105 women aged 18-35 years presenting with clinically diagnosed moderate-to-severe acne. Participants were included using a consecutive sampling technique until the required sample size was achieved. Data were analyzed using SPSS version 26.0. Results: Among 105 women with moderate-to-severe acne, the mean age was 26.1±4.7 years, and 40.0% were diagnosed with PCOS. PCOS was significantly associated with higher BMI and waist circumference, menstrual irregularity, hirsutism, acanthosis nigricans, hyperandrogenemia, insulin resistance, and elevated triglycerides. At least one metabolic abnormality was present in 69.0% of women with PCOS compared with 36.5% without PCOS (p=0.001), while severe acne was significantly associated with higher frequencies of PCOS (51.2%), hirsutism, menstrual irregularity, insulin resistance, and central obesity than moderate acne. Conclusion: The study revealed a substantial prevalence of PCOS and metabolic disturbances among women with moderate-to-severe acne, with 40.0% fulfilling the criteria for PCOS. PCOS was significantly linked to menstrual irregularities, hirsutism, acanthosis nigricans, increased BMI and waist circumference, hyperandrogenemia, insulin resistance, and dyslipidemia. Furthermore, women with severe acne had significantly higher frequencies of PCOS, insulin resistance, and central obesity, indicating a close relationship between acne severity and underlying endocrine-metabolic abnormalities.