Abstract
Background: Polycystic ovary syndrome (PCOS) is a prevalent endocrine disorder in reproductive-age women, frequently accompanied by hyperprolactinemia. The interplay between prolactin, follicle-stimulating hormone (FSH), and metabolic parameters in PCOS remains incompletely characterized.
Objective: To assess the prevalence of hyperprolactinemia among PCOS patients and examine its associations with FSH, LH/FSH ratio, BMI, and metabolic markers. Methods: A cross-sectional study was conducted at a tertiary hospital in Lahore involving 100 female participants (age 21–27 years; mean 23.95 ± 1.73). PCOS was diagnosed per Rotterdam criteria. Serum prolactin, FSH, LH, testosterone, and BMI were measured. Descriptive statistics, Pearson/Spearman correlations, independent t-tests, and binary logistic regression were performed in SPSS. Results: All 100 participants were hyperprolactinemic (prolactin >25 ng/mL; mean 35.78 ± 5.73 ng/mL), and 81% met PCOS criteria. The mean LH/FSH ratio was 2.82 (>2 threshold), and mean testosterone was 87.36 ng/dL. BMI was very strongly correlated with prolactin (r = 0.984, p < 0.001) and negatively with FSH (r = −0.971, p < 0.001). Prolactin and FSH were inversely correlated (r = −0.969; Spearman ρ = −0.994, p < 0.001). No statistically significant differences in hormonal parameters were found between PCOS-positive and PCOS-negative groups, attributable to uniform hyperprolactinemia across the cohort. Logistic regression was non-significant overall, though LH/FSH ratio showed the highest odds ratio (OR = 19.131). Conclusion: Hyperprolactinemia is common in PCOS and is strongly associated with elevated BMI and suppressed FSH, suggesting a hormonal axis disruption contributing to anovulation. Routine prolactin assessment is warranted in PCOS evaluation. Larger controlled studies are needed to establish causality and evaluate prolactin-targeted therapies