Original article| Volume 21, ISSUE 3, P191-198, May 2011

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A Comparison of Polycystic Ovary Syndrome and Related Factors Between Lesbian and Heterosexual Women

Published:February 11, 2011DOI:



      Polycystic ovary syndrome (PCOS) is a common reproductive endocrine disorder associated with infertility, cardiovascular disease and type 2 diabetes. Despite anecdotal evidence that lesbians may have higher PCOS rates than heterosexuals, little empirically based evidence supports this theory. To address this gap, we examined PCOS prevalence and associated factors among a community sample of lesbian and heterosexual women.


      Lesbian (n = 114) and heterosexual (n = 97) women aged 35 to 45 who participated in The Epidemiologic STudy of HEalth Risk (ESTHER) Project (Pittsburgh, PA) were recruited into our PCOS exploratory study between April and October 2008. A reproductive endocrinologist, “blinded” to participant sexual orientation, identified women with PCOS using a modified version of the 2003 Rotterdam Diagnostic Criteria for PCOS. Sexual orientation was defined by self-reported sexual identity, behavior, and attraction. Fisher’s exact, chi-square, and Wilcoxon rank-sum tests were used for analysis.


      Approximately 6.2% (n = 13) of the total sample (n = 211) had PCOS. PCOS rates did not significantly differ between lesbian and heterosexual women ([7.9%, n = 9] vs. [4.1%, n = 4]; p = .256). No significant differences in PCOS-related factors were found between lesbian and heterosexual women: polycystic ovaries ([10.5%, n = 12] vs. [6.2%, n = 6]; p = 0.261), hirsutism ([24.6%, n = 28] vs. [15.5%, n = 15]; p = 0.102), oligomenorrhea ([3.6%, n = 4] vs. [5.4%, n = 5]; p = 0.735), adult acne ([21.1%, n = 24] vs. [24.7%, n = 24], p = 0.524), and median testosterone ([1.69 ng/mL, n = 114] vs. [1.52 ng/mL, n = 97]; p = 0.069) and androstenedione ([1.63 ng/mL, n = 114] vs. [1.51 ng/mL, n = 97]; p = 0.079) concentrations, respectively.


      PCOS and related factors did not differ by sexual orientation. Despite this, our observed rates warrant the need for additional studies to examine the relationship between PCOS diagnoses, PCOS-related factors, and sexual orientation.
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      Helen A. Smith, PhD, MPH, MA, is a postdoctoral fellow at the Center for Research on Health Care, Department of Medicine at the University of Pittsburgh. Her research is focused on health disparities among sexual minority women. She obtained her PhD in Epidemiology and MPH in Behavioral and Community Health Sciences from the University of Pittsburgh. She also received her MA in Human Sexuality Studies from San Francisco State University.


      Nina Markovic, PhD, is an Associate Professor, Dental Public Health and Epidemiology, University of Pittsburgh. Over the past 15 years her primary interest has focused on research related to the health status of women, and more especially, lesbian women. She is the Co-Principal Investigator for the Epidemiologic Study of Health Risk in Women (ESTHER), and Co-Director for the LGBT Health & Wellness Certificate Program at the Graduate School of Public Health, University of Pittsburgh.


      Alicia K. Matthews, PhD, is a clinical psychologist and Associate Professor in the College of Nursing at the University of Illinois at Chicago. She has more than 15 years experience conducting health disparities research. Her primary research agenda is focused on cancer prevention and control in racial/ethnic and sexual minority populations. She has received federal, state and foundation grants to support her research. Currently, is the PI or Co-I on grants focused on smoking cessation among HIV+ MSM, predictors of alcohol use among sexual minority women, and the development of culturally targeted cancer screening patient navigation materials for non-adherent LGBT adults.


      Michelle E. Danielson, PhD, Research Associate, received her PhD in Epidemiology at the University of Pittsburgh in 1995. She currently serves as a Research Associate in the Department of Epidemiology and a Co-investigator/Project Coordinator for several large-scale epidemiologic studies related to aging, osteoporosis and women's health. Her research interests also include sexual minority health. She serves as a Co-Investigator on the Epidemiologic Study of Health Risk in Women (ESTHER), a project examining cardiovascular risk and health behaviors in a large sample of lesbian and heterosexual women.


      Brinda N. Kalro, MD, is a Consultant in Reproductive Endocrinology and Infertility at Kokilaben Dhirubhai Ambani Hospital, Mumbai, India. After completing her fellowship in Reproductive Endocrinology and Infertility, she joined the faculty as an Assistant Professor at Magee Women's Hospital, University of Pittsburgh. In July 2009, she relocated to India and joined the Kokilaben Dhirubhai Ambani Hospital, Mumbai, to head the Reproductive Endocrine and Assisted Reproduction Program.


      Ada O. Youk, PhD, is an Assistant Professor at the University of Pittsburgh in the Department of Biostatistics. Her research areas of interest include: occupational biostatistics and epidemiology, statistical methodology for missing data in occupationally exposed cohorts, application of occupational risk regression modeling to pharmaceutical data, longitudinal data analysis for assessing levels of depression in peri-menopausal women as they make the menopausal transition, and assessing cancer mortality in high altitude areas.


      Evelyn O. Talbott, DrPh, is a Professor in the Department of Epidemiology at the University of Pittsburgh. Her major research interests are in cardiovascular disease risk factors in women, including those with Polycystic Ovary Syndrome. She is also very involved in environmental risk factors such as air pollution and their effect on cardiovascular and respiratory disease.