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Reproductive Endocrinology

MON-177 - The Prevalence and Phenotype of PCOS in A Community-Based Population in Sub-Sahara Africa: The Nigeria-PEP Study

Monday, June 15, 2026
9:00 AM - 2:00 PM CT
Location: ENDOExpo; Poster Floor
Disclosure(s):
Ricardo Azziz, MD, MBA, MPH: Core Acess Surgical Technologies: Consultant (); May Health: Consultant (); Postera: Consultant (); Quest Diagnostics: Grant Recipient (); Quest Foundation: Grant Recipient (); Tellurian Global, LLC (dba SPH Consulting Group): Owner/Co-Owner Founder/Co-Founder ()


Background: Epidemiologic studies of unselected populations indicates that he Polycystic Ovary Syndrome (PCOS) is present in 10%-20% of reproductive-aged women. No systematic studies of PCOS have been performed in Sub-Sahara Africa, limiting the ability to public health approaches to address the disorder. To address this, we established the ‘PCOS Epidemiology and Phenotype in Nigeria (Nigeria-PEP)’ study.

Objective: To determine the prevalence and phenotype of PCOS in a medically unbiased population in Nigeria.
Materials and methods: Participants were reproductive-aged women (18-45 years.) selected using a multi-stage sampling technique from Local Government Areas of Lagos, Nigeria. Anthropometric measurements were determined, and the degree of hirsutism assessed using the modified Ferriman-Gallwey (mF-G) method. Subjects underwent a 75 gm, 2-hr. oral glucose tolerance test and a pelvic ultrasonography between day 2 and 7 of the cycle, or randomly for women who had a negative progesterone challenge test. Hyperandrogenism (HA) was defined as a mF-G score of ≥5 for clinical hyperandrogenism (based on k2-cluster analysis of the entire population) and/or androgen values (total or free testosterone) exceeding the 98th percentile of a ‘healthy control’ subset (i.e., 104 non-hirsute healthy eumenorrheic women without significant medical conditions or medications). Ovulatory dysfunction (OD) was defined as menstrual cycle lengths >35 or < 21 days and/or a mid-luteal phase serum progesterone < 4 ng/mL. Polycystic ovarian morphology (PCOM) was defined as antral follicle count of ≥20 in 2-9 mm diameter and/or ovarian volume ≥ 10 cm3 at least in a single ovary. PCOS was defined according to the international evidence-based guideline, with a weighted probability score calculated and assigned to participants with ‘possible PCOS’ but incomplete evaluation.

Results: A total of 440 participants were recruited (mean±SD age 32.27±8.63 yrs). Twenty-seven (6.1%) participants were underweight (BMI < 18.5), 220 (50.0%) had normal BMI, 97 (22.1%) were overweight, and 96 (21.8%) were obese (BMI≥ 30 kg/m2). Of the participants recruited, 118 (26.8%) had HA, 126 (28.6%) had OD, and 153 (34.8%) had PCOM. Overall, the prevalence rate of PCOS was 22.7% (100/440). Of women with PCOS, 19 (19.0% of all PCOS and 4.3% of the total population) had HA+OD+PCOM (i.e., PCOS Phenotype A), 20 (20.0% and 4.6%) had HA+OD (PCOS Phenotype B), 41 (41.0% and 9.3%) had HA+PCOM (PCOS Phenotype C), and 20 (20.0% and 4.6%) had OD+PCOM (PCOS Phenotype D).

Conclusion: The prevalence of PCOS in a medically unbiased Nigerian population of reproductive-aged women is 22.7%, higher than reported in other populations. Phenotype C appears to be the predominant phenotype. Further studies with this population are ongoing.

*Unless otherwise noted, all abstracts presented at ENDO must not be released to the press or the public until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.*