Relevance. Up to now there is no universal definition to define polycystic ovarian syndrome yet Polycystic ovarian syndrome (PCOS) which is also called as Schlerocystic Ovaries, Multicystic ovaries, Stein Leventhal Syndrome, Ovarian Hyperandrogenic dysfunction and etc is a complex condition which mainly characterized by elevated androgen levels, menstrual irregularities, and small cysts on one or both ovaries [4, 6].

PCOS is a multi factorial pathology where the both genetic and environmental factors determine the heterogeneous, clinical and biochemical phenotype of the disease which involves different mechanisms of pathogenesis depending on the patient [1, 3, 4].

This pathology has many aspects to it. Among them metabolic and endocrinopathic aspects highlights the most; so that PCOS itself is more of a metabolic and endocrinopathic disorder rather than just a gynecological disease, which  leads PCOS to be the most common endocrine pathology in females of reproductive age worldwide [4, 6].

So that it is associated with infertility, metabolic syndrome, obesity, impaired glucose tolerance, type 2 diabetes mellitus (DM-2), dyslipidemia, cardiovascular risk, depression, obstructive sleeps apnea (OSA), endometrial cancer and nonalcoholic fatty liver disease/ nonalcoholic steatohepatitis (NAFLD/NASH) also [2, 5].

Diagnosing the PCOS is hard during age around puberty as most of its manifestations are similar to the pubertal manifestations, But with increasing of age it will tend to develop more metabolic and endocrinopathic abnormalities rather than gynecological manifestations [3, 6].

And the treatment concerns the specific needs of the individual patient which mainly involves restoring fertility, correction of metabolic and endocrinopathic abnormalities. In time treatment can improve the quality of life and prevention of the risks of having more serious and life threatening complications in later life [1, 3, 5].

Objective: comparative analyze of the structure and frequency of etiological factors of polycystic ovarian syndrome in Sri Lanka and Russia.

Research objectives:

1. Evaluate the structure and the causes for polycystic ovarian syndrome in Russia.

2. Evaluate the structure and the causes for polycystic ovarian syndrome in Sri Lanka.

3. Conduct a comparative analysis of the frequency of causes for polycystic ovarian syndrome in Sri Lanka and Russia.

Materials and methods. Anamnesis data, clinical symptoms, physical examination, laboratory and instrumental methods of examination of patients diagnosed with polycystic ovary syndrome were analyzed.

Results of the study.

Main etiological factors for PCOS in Russia:

1. Abnormalities of menstrual and reproductive function in the mother and close relatives 5%
2. Complicated course of pregnancy in the mother (preeclampsia, diseases of the cardiovascular system, nervous and endocrine) 7%
3. Concomitant infectious diseases during pregnancy 5.5%
4. Embryophetopathy of viral etiology 6.4%
5. Hormonal treatment of preterm labor (estrogens stimulate increased secretion of androgens) 2.5%
6. Infectious diseases in childhood and puberty 7.5%
7. Chronic inflammatory diseases of the reproductive system 10%
8. Long-term use of hormonal drugs 8.5%
9. Endocrinopathies (neuroendocrine-metabolic syndrome, Itsenko-Cushing’s disease and syndrome, hyperprolactinemia) 27%
10. Insulin resistance and hyperinsulinemia 35%
11. Obesity 35%

Main etiological factors for PCOS in Sri Lanka:

1. Ethnicity (social and demographical influence), among people with PCOS;

• Sinhalese 86.1%
• Muslims 8.1%
• Sri Lankan Tamils 3.8%

1. Abnormalities in the menstrual cycle of the mother and first degree relatives of the patient – 7.7%
2. Patients with complicated pregnancy (preeclampsia) – 5%
3. Women with insulin resistance and type 2 diabetes mellitus – 52.9%
4. Family history of type 2 DM (in first degree relatives) – 48%, Among those 48% there are 18.6% with more than one affected family member.
5. Primary hypothyroidism of autoimmune origin – 5.97%
6. Obesity

• Women age 15-19 – 21%
• Women age 20-29 – 33%
• Women age 30-39 – 46%
• Women age 40-49 – 53%

2. Physical activity levels;

• inactive–38.8%, moderately active’–33.5%, and ‘active’–21.1%

1. Patients with metabolic syndrome – 28.3%
2. The patients with impaired fasting glucose – 13.9%
3. Primary hypothyroidism of autoimmune origin – 5.97%
4. Woman with cancers;

• Patients with endometrial carcinoma – 6.4% among the all cancers with age between 50 to 64 years.
• Patients with breast cancer – 20%
• Patients with ovarian cancer – 6%

3. Kisspeptin levels are also relatively high among sri lankan women.

Tabl. 1. Comparative analysis of the frequency of causes for polycystic ovarian syndrome in Sri Lanka and Russia.

Conclusions. The most common causes for the contribution of PCOS in Russia are; Endocrinopathies such as neuroendocrine-metabolic syndrome, Itsenko-Cushing’s disease and syndrome and hyperprolactinemia (27%), patients with obesity (35%), Patients with insulin resistance, DM type 2 or hyperinsulinemia. (35%), patients with breast cancer (20.9%), and chronic inflammatory diseases of the reproductive system 10%.

The most common causes for the contribution of PCOS in Sri Lanka are; Abnormal menstrual and reproductive function in patients mother or close relatives (7.7%), Patients with metabolic syndrome (28.3%), patients with obesity (33%), Patients with insulin resistance, DM type 2 or hyperinsulinemia (52.9%), patients with breast cancer (20%), and kisspeptin levels are relatively high among Sri Lankan women also.

The comparative analysis of the causes for PCOS in Russia and Sri Lanka, showed that in both countries there is significantly large percentage of misbalanced metabolism and metabolic syndrome, obesity, insulin resistance, type 2 DM/hyperinsulinemia, and breast cancer contribute to the occurrence of PCOS in patients. As a conclusion the most common cause for the occurrence of PCOS in Russia are obesity and insulin resistance while the most common cause for PCOS in Sri Lanka is the  insulin resistance/type 2 DM.

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