Correlation between menstrual cycle disturbances and polycystic ovary syndrome in reproductive-aged women with iodine deficiency

Abstract

The intersection of endemic environmental micronutrient deprivation and intrinsic ovarian dysfunction presents a formidable diagnostic challenge within modern reproductive endocrinology. This study rigorously investigates the pathophysiological interrelation between menstrual cycle disruptions and polycystic ovary syndrome among females residing in regions characterized by severe iodine deficiency. Utilizing a stratified, cross-sectional analytical framework, clinical data was acquired from a cohort of 215 females presenting with confirmed hyperandrogenic anovulation and concomitant morphological ovarian alterations. Empirical analysis exposed an amplified clinical phenotype within the iodine-deficient demographic, where 72.4% exhibited severe oligomenorrhea with cycle lengths routinely exceeding 55 days, directly contrasting the 41.8% prevalence in iodine-sufficient controls. Structural biochemical modeling demonstrated a severe inverse correlation between median urinary iodine concentrations and spontaneous menses frequency. This chronobiological disruption is primarily driven by subclinical hypothyroid-induced suppression of hepatic sex hormone-binding globulin synthesis, which plummeted to 22.5 ± 3.8 nmol/L in the experimental group. The resulting unchecked proliferation of unbound peripheral testosterone drastically distorted the local intraovarian microenvironment, precipitating premature follicular arrest and secondary amenorrhea. High-resolution ultrasonography corroborated these deviations, revealing significantly higher antral follicle counts and elevated ovarian volumes in iodine-depleted subjects. The integrated data unequivocally dictates that geographic iodine status acts as a powerful pathogenic amplifier of gonadal dysregulation, requiring aggressive thyroid optimization and targeted iodine replenishment prior to initiating conventional ovulation-inducing pharmacotherapy.