PREVALENCE OF URINARY TRACT INFECTIONS AMONG WOMEN WITH POLYCYSTIC OVARY SYNDROME AND ITS HORMONAL CORRELATES

Abstract

Background: Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder affecting reproductive-aged women, often associated with hormonal and metabolic imbalances. While its reproductive and metabolic implications are well-documented, its potential link to urinary tract infections (UTIs) remains underexplored.

Objective: To determine the prevalence of UTIs among women with PCOS and investigate the hormonal and metabolic correlates contributing to increased susceptibility.

Methods: A cross-sectional study was conducted over four months in Sindh, involving 355 women diagnosed with PCOS based on Rotterdam criteria. Midstream urine samples were collected for culture-based confirmation of UTI. Serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, testosterone, DHEA-S, sex hormone-binding globulin (SHBG), and insulin resistance (HOMA-IR) were measured. Statistical analyses included descriptive statistics, independent t-tests, Pearson correlation, and binary logistic regression.

Results: Of the 355 participants, 108 (30.4%) were UTI positive. Women with UTIs had significantly higher testosterone (68.7 ± 20.5 ng/dL), lower estradiol (45.1 ± 12.4 pg/mL), reduced SHBG (26.8 ± 9.5 nmol/L), and elevated HOMA-IR (3.4 ± 1.2), all with p-values < 0.05. Logistic regression revealed testosterone (OR=1.34), estradiol (OR=0.89), SHBG (OR=0.94), and HOMA-IR (OR=1.22) as independent predictors of UTI.

Conclusion: A substantial proportion of women with PCOS were found to have UTIs, strongly associated with androgen excess, estrogen deficiency, and insulin resistance. These findings emphasize the need for comprehensive clinical management in PCOS that includes attention to urinary health and infection risk.