MON-184 - The Prevalence and Phenotype of Polycystic Ovary Syndrome (PCOS) in A Community-Based Population in Trinidad

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among reproductive-aged women, with prevalence estimates ranging from 5–15% in medically unselected populations worldwide. However, data from the Caribbean are scarce, limiting evidence-based screening, prevention, and public-health planning in this region. Trinidad, a multi-ethnic Caribbean nation, lacks population-based estimates of PCOS prevalence and phenotypic distribution.To determine the prevalence and clinical–biochemical phenotype of PCOS in an unselected, community-based population of reproductive-aged women in Trinidad.The PCOS Epidemiology and Phenotype in Trinidad (Trinidad-PEP) study recruited women aged 18–45 years using random sampling across eight major geographic regions of Trinidad. Participants completed standardized clinical assessments for menstrual dysfunction (MD) and clinical hyperandrogenism (CH), including a modified Ferriman–Gallwey score. Blood samples were collected for thyroid-stimulating hormone (TSH), prolactin, 17-hydroxyprogesterone (17-OHP), total testosterone, and free testosterone. Cluster analysis was used to empirically derive biochemical cut-offs. CH was defined as a Ferriman–Gallwey score ≥5, MD as menstrual cycles < 25 or >35 days, total testosterone >35 ng/dL, and free testosterone >4.7 pg/mL. Women with elevated TSH (>4.8 μIU/mL), prolactin (>25 ng/mL), or 17-OHP (>200 ng/dL) were evaluated to exclude alternative diagnoses. Participants were classified as PCOS, probable PCOS (PROB-PCOS), or no PCOS based on combined clinical and biochemical criteria following the Updated International Guidelines 2023.Among 250 women, 26 met strict criteria for PCOS. Using weighted probability estimates to account for PROB-PCOS classifications, the estimated total number of PCOS cases was 38.8, corresponding to a population prevalence of 15%. PCOS phenotypes demonstrated substantial heterogeneity, with varying combinations of MD, CH, and biochemical androgen excess.This first community-based epidemiologic study of PCOS in Trinidad demonstrates a prevalence at the upper range of global estimates, highlighting a substantial and previously under-recognized burden of disease. The findings underscore the need for region-specific screening strategies and public-health interventions and provide a critical foundation for future research on cardiometabolic and mental-health sequelae of PCOS in Caribbean populations.

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