Serum Testosterone and Menstrual Irregularity Among Reproductive-Age Pakistani Women: A Hospital-Based Cross-Sectional Study from Sialkot

Abstract

Background: Serum Testosterone and Menstrual Irregularity Among Reproductive-Age Pakistani Women: A Hospital-Based Cross-Sectional Study from Sialkot Background: Polycystic ovary syndrome (PCOS) is a multifactorial endocrine disorder characterized by hyperandrogenism, ovulatory dysfunction, and metabolic abnormalities. South Asian women exhibit higher PCOS prevalence and metabolic risk compared to Western counterparts, yet biochemical data from Pakistan remain limited. Elevated serum testosterone is a hallmark of PCOS and a potential marker of menstrual irregularity, but its diagnostic relevance in local populations requires validation. Objective: To examine the association between serum testosterone levels, PCOS status, and menstrual irregularity in reproductive-age Pakistani women. Methods: A cross-sectional study was conducted on 100 women aged 23–35 years recruited from one public and one private hospital in Sialkot. Participants completed standardized questionnaires assessing menstrual pattern and PCOS-related symptoms. Serum total testosterone was analyzed using enzyme-linked immunosorbent assay (ELISA). Statistical analyses included Pearson correlation and binary logistic regression with p < 0.05 considered significant. Results: Mean age was 29.5 ± 3.3 years, and mean serum testosterone was 1.73 ± 1.05 ng/mL. Testosterone strongly correlated with PCOS status (r = 0.809, p < 0.001) and menstrual irregularity. Regression analysis revealed that each 1 ng/mL increase in testosterone raised the odds of PCOS 6.8-fold and menstrual irregularity 3.8-fold (p < 0.001). Conclusion: Elevated serum testosterone is a robust predictor of PCOS and menstrual disturbance in Pakistani women, underscoring its diagnostic and clinical utility in reproductive-endocrine screening.