Differences in Prevalence of Polycystic Ovary Syndrome Diagnosis Across Sexual Orientation in a Longitudinal Cohort of U.S. Adults.

Abstract

Purpose: The purpose was to investigate differences in polycystic ovary syndrome (PCOS) prevalence by sexual orientation among young adults in the United States.

Methods: We used data from the Growing Up Today Study, a longitudinal cohort of young adults (age 23-35 in 2019). Participants assigned female at birth (N = 11,148) reported PCOS diagnoses on questionnaires between 2010 and 2019. We used modified-Poisson regression models to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for PCOS diagnoses, comparing completely heterosexual participants (referent) to sexual minority participants (i.e., heterosexual with same-sex partnership, mostly heterosexual, bisexual, and lesbian). We also assessed whether health care utilization modified the association between sexual orientation and PCOS diagnosis. Models were adjusted for age and race/ethnicity.

Results: The overall prevalence of PCOS in the sample was 8.1%. Compared to completely heterosexual participants, sexual minority participants had a higher adjusted prevalence of PCOS diagnosis (PR: 1.28, 95% CI: 1.12-1.46). Within sexual minority subgroups, mostly heterosexual (PR: 1.24, 95% CI: 1.06-1.45), bisexual (PR: 1.69, 95% CI: 1.29-2.22), and lesbian (PR: 1.50, 95% CI: 1.04-2.16) participants had an elevated prevalence of PCOS compared to completely heterosexual participants. Differences in PCOS diagnosis persisted within strata of time since the last routine physical exam.

Conclusion: These findings provide some of the first estimates of PCOS among sexual minority people, emphasizing the need to address differences in reproductive health among sexual minority young adults. They also reveal that health care utilization increases the likelihood of receiving a diagnosis and highlight the importance of health care access.