Prevalence and Risk Factors of Polycystic Ovary Syndrome Among Adolescent Girls in Urban and Rural Areas of Punjab, Pakistan

Background: Polycystic ovary syndrome (PCOS) is a leading endocrine disorder during adolescence, conferring reproductive, metabolic, and psychological burdens. Reliable estimates from Pakistan—particularly contrasting urban and rural settings—remain scarce. Objective: To estimate the prevalence of PCOS and delineate its principal risk correlates among adolescent girls residing in urban and rural districts of Lahore, Pakistan. Methods: A cross‑sectional survey was undertaken between January and December 2024. Sixty girls aged 13–19 years were recruited by purposive sampling, with equal representation from urban and rural communities. Standardised questionnaires captured sociodemographic and lifestyle variables; physical and anthropometric assessments, transabdominal ultrasonography, and fasting biochemical profiles were obtained. PCOS was defined according to the Rotterdam criteria. Data were analysed with SPSS (version 25.0). Results: The overall prevalence of PCOS was 26·7%. Urban participants demonstrated a significantly higher prevalence than their rural counterparts (36·7% vs 16·7%; p = 0·04). Urban residency was associated with elevated body‑mass index, greater waist circumference, a higher proportion of obesity, sedentary behaviour, and frequent fast‑food intake. Menstrual irregularity, acne, and hirsutism were the predominant clinical manifestations. Biochemically, girls with PCOS exhibited raised serum testosterone, fasting insulin, fasting glucose, and HOMA‑IR indices (all p < 0·05). A positive familial history of PCOS was more common among urban respondents. Conclusion: PCOS affects more than one in four adolescent girls in Lahore, with a markedly greater burden in urban communities driven by adiposity, lifestyle patterns, and hereditary predisposition. Early detection, focused health education, and targeted lifestyle modification programmes are essential to mitigate future cardiometabolic and reproductive sequelae.